Controversies in the therapy of low-grade glioma: when and how to treat.

Treatment of low-grade gliomas is one of the most challenging management dilemmas in neuro-oncology. Young age of onset and low rate of growth theoretically favor minimally invasive treatments. Yet, local recurrence and conversion to malignant glioma are the expected outcome within 4-8 years from diagnosis and impose the use of additional therapies, such as radiotherapy and chemotherapy. Due to low incidence and paucity of randomized trials, the correct timing and dosage of radiotherapy are still controversial, as well as the indications and possible benefits of the administration of cytotoxic drugs. Current concepts and future perspectives in the treatment of low-grade gliomas drawn from recent scientific literature are here summarized and discussed.