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Radiotherapy is the most effective nonsurgical treatment for gliomas. Its role in the treatment of malignant gliomas is well defined, but its efficacy and optimal timing of administration for low-grade gliomas is less clear. Most patients with low-grade glioma are adults in their 20s or 30s who present with seizures and have a nonenhancing mass on neuroimaging. The majority of these patients are neurologically intact and their seizures are easily controlled with anticonvulsants. Typically, radiotherapy was employed immediately to control disease and delay malignant progression. However, in the past 10 to 20 years it has become increasingly apparent that radiotherapy may be associated with long-term cognitive dysfunction. Furthermore, its true benefit and its long-term cognitive risks have been difficult to establish. There is now a growing body of evidence that suggests that deferring radiotherapy in patients with low-grade glioma has no deleterious effects on …
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