Surgery is the only means to eradicate pediatric low-grade gliomas (LGGs), provided that they are located in areas of the brain where complete resection can be achieved. In contrast, LGGs located in areas of the brain where complete resection is not possible can severely affect patient function and life. So to compare 2 chemotherapy regimens used to treat LGGs in patients younger than 10 years of age (a group of patients who radiologists consider unsuitable for radiotherapy because of the potential for neurological damage), Ater et al. from the University of Texas MD Anderson Cancer Center conducted a study. The results of the study were recently published online in JCO. This study included previously untreated children younger than 10 years of age with progressive or residual LGGs. These patients were randomized to 2 groups, with 1 group receiving carboplatin and vincristine (CV) and the other group receiving thioguanine, methylbenzylhydrazine, lomustine and vincristine (TPCV). The final study included 274 patients, 137 each in the CV and TPCV groups. The 5-year event-free survival (EFS) and overall survival (OS) rates for all patients were 45% ± 3.2% and 86% ± 2.2%, respectively. 5-year EFS rates were 39% ± 4% in the CV group and 52% ± 5% in the TPCV group (stratified log-rank test, P = 0.10; P = 0.007 for cure model analysis). In multivariate analysis, younger age and tumors larger than 3 cm2 were independent predictors of poorer EFS and OS. OS was relatively poor for tumors located in the thalamus. It can be concluded that the difference in EFS between the 2 chemotherapy regimens did not reach statistical significance based on the stratified log-rank test. However, based on the cure model analysis, then the 5-year EFS was higher in the TPCV group. the difference in toxicity between the 2 chemotherapy regimens may influence the clinician’s choice of treatment options.