Low grade gliomas (LGGs) are a group of primary brain tumors usuallyencountered in young patient populations. These tumors represent a difficultchallenge because many patients survive a decade or more and may be at a higherrisk for treatment-related complications. Specifically, radiation therapy isknown to have a relevant effect on survival but in many cases it can bedeferred to avoid side effects while maintaining its beneficial effect.However, a subset of low-grade gliomas manifests more aggressive clinicalbehavior and requires earlier intervention. Moreover, the effectiveness ofradiotherapy depends on the tumor characteristics. Recently Pallud et al.,[Neuro-oncology, 14(4):1-10, 2012], studied patients with LGGs treated withradiation therapy as a first line therapy. and found the counterintuitiveresult that tumors with a fast response to the therapy had a worse prognosisthan those responding late. In this paper we construct a mathematical modeldescribing the basic facts of glioma progression and response to radiotherapy.The model provides also an explanation to the observations of Pallud et al.Using the model we propose radiation fractionation schemes that might betherapeutically useful by helping to evaluate the tumor malignancy while at thesame time reducing the toxicity associated to the treatment.
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