Brain tumor research in Korea: Glioma treatment and hope for survival

Navigating Brain Tumors: Survival Insights for Grade II Gliomas

Theo Raines in Health & Wellness October 2025 • 4 min read.

"A Korean study sheds light on effective treatment strategies for WHO Grade II gliomas, offering hope and clarity for patients and their families."

Low-grade gliomas (LGGs), classified as Grade II tumors by the World Health Organization (WHO), present unique challenges in treatment. These tumors, including astrocytomas, oligoastrocytomas, and oligodendrogliomas, are rare, accounting for less than 20% of all confirmed gliomas. Unlike higher-grade gliomas, LGGs typically offer a more favorable prognosis, with survival often reaching seven years or more.

Optimal treatment strategies for LGGs have long been a subject of debate in oncology. While surgery, particularly gross total resection (GTR), is considered a primary intervention, the role of adjuvant therapies like radiotherapy (RT) and chemotherapy remains less clear. Clinical trials have explored various approaches, from dose escalation in RT to combining chemotherapy, yet establishing definitive guidelines has proven difficult.

A recent study, a collaborative effort between the Korean Neuro-Oncology Group (KNOG) and the Korean Radiation Oncology Group (KROG), has provided valuable insights into the treatment outcomes for adult LGG patients in Korea. By analyzing a comprehensive dataset, the researchers aimed to identify prognostic factors and evaluate the impact of different treatment modalities on progression-free survival (PFS) and overall survival (OS).

Key Findings on Survival and Treatment Efficacy

Brain tumor research in Korea: Glioma treatment and hope for survival

The study, which reviewed the medical records of 555 patients diagnosed with WHO grade II LGG between 2000 and 2010, revealed several significant associations. The median follow-up time was 83.4 months, providing a robust dataset for analysis. The five-year PFS and OS rates were 52.2% and 83.0%, respectively, offering a benchmark for understanding long-term outcomes.

Several factors were found to be associated with poorer survival rates, including:

Male sex
Older age
Poorer performance status
Multiple lobe involvement
Astrocytoma histology

Among the treatment-related factors, gross total resection (GTR) emerged as a key predictor of improved outcomes. Patients who underwent GTR experienced better PFS and OS rates. Adjuvant chemotherapy was also associated with improved PFS. Interestingly, adjuvant radiotherapy (RT) did not improve PFS; in fact, it correlated with poorer OS. However, after propensity-score matching (PSM) to correct imbalances in patient/tumor characteristics, the researchers observed a potential tendency for improved PFS in the RT group.

Real-World Impact and Future Directions

This study underscores the importance of GTR in improving survival for LGG patients and suggests that adjuvant chemotherapy may enhance PFS. While adjuvant RT did not improve overall survival outcomes, the PSM analysis revealed potential impacts on PFS, suggesting that RT may still have a role in certain clinical scenarios. These results reflect real-world practices and can help optimize treatment strategies for LGG, potentially leading to improved outcomes and survival rates. Further research, particularly studies incorporating molecular biomarkers, will be crucial for tailoring treatments and refining prognostic assessments in LGG management.

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Everything You Need To Know

What are the key types of WHO Grade II gliomas discussed in this study?

The study focuses on WHO Grade II gliomas, which include astrocytomas, oligoastrocytomas, and oligodendrogliomas. These are classified as low-grade gliomas (LGGs) and are distinct from higher-grade gliomas. Understanding the specific type of glioma is crucial because it influences the prognosis and treatment approach.

How does gross total resection (GTR) impact the survival of patients with WHO Grade II gliomas?

Gross total resection (GTR) is a significant factor in improving outcomes for patients with WHO Grade II gliomas. The study found that patients who underwent GTR experienced better progression-free survival (PFS) and overall survival (OS) rates. This underscores the importance of surgical intervention to remove as much of the tumor as possible, which is considered a primary treatment intervention.

What role does adjuvant chemotherapy play in the treatment of WHO Grade II gliomas, according to the study?

The study indicates that adjuvant chemotherapy is associated with improved progression-free survival (PFS) in patients with WHO Grade II gliomas. This suggests that combining chemotherapy with other treatments, such as surgery, can help to delay or prevent the progression of the disease. The findings support the use of chemotherapy as part of the treatment strategy, potentially enhancing the overall management of LGGs.

Why did adjuvant radiotherapy (RT) show mixed results in the study of WHO Grade II gliomas, and what do these findings imply?

The study showed that adjuvant radiotherapy (RT) did not initially improve progression-free survival (PFS) and even correlated with poorer overall survival (OS). However, after propensity-score matching (PSM) to correct for imbalances, there was a potential tendency for improved PFS in the RT group. This suggests that the impact of RT may depend on patient and tumor characteristics, and it might still play a role in specific clinical scenarios. The findings highlight the complex interplay between different treatment modalities and patient-specific factors in LGG management.

What factors were found to be associated with poorer survival rates in patients diagnosed with WHO Grade II gliomas in the Korean study, and what do these mean for patient care?

Several factors were associated with poorer survival rates. These include male sex, older age, poorer performance status, multiple lobe involvement, and astrocytoma histology. These factors provide crucial prognostic information for healthcare providers, helping to stratify patients based on their risk level and tailor treatment plans accordingly. For example, patients with multiple adverse prognostic factors might benefit from more aggressive treatment strategies, while those with more favorable factors might be candidates for less intensive approaches. This personalization of treatment is key to improving outcomes.