2022 Background: Optimal adjuvant management of low-grade gliomas (LGGs) remains controversial. Radiotherapy has been shown to improve progression-free survival compared to observation, but carries the potential for substantial late toxicity. In an effort to delay or obviate the need for radiation, there has been increasing interest in the use of adjuvant chemotherapy in LGGs. However, there is a dearth of prospective studies with long-term follow-up evaluating the efficacy of adjuvant chemotherapy without radiation in patients with newly diagnosed LGGs. Methods: Patients over the age of 18 with histologically proven supratentorial LGG (WHO grade II) who underwent subtotal resection or biopsy were eligible for enrollment. Daily temozolomide (TMZ) was administered at 200 mg/m2 for 5 days, and repeated every 28 days for up to 12 cycles or until disease progression. Patients were assessed for radiographic response and progression with MRIs every two months during and after treatment. The primary outcome was ...