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PCV chemotherapy alone for WHO grade 2 oligodendroglioma: prolonged disease control with low risk of malignant progression.
- Source :
-
Journal of neuro-oncology [J Neurooncol] 2021 Jun; Vol. 153 (2), pp. 283-291. Date of Electronic Publication: 2021 May 01. - Publication Year :
- 2021
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Abstract
- Introduction: The role of chemotherapy alone in newly diagnosed WHO grade 2 oligodendroglioma after biopsy, incomplete or gross total resection remains controversial. We here analyze the clinical outcome of four patient cohorts being treated with either procarbazine, CCNU and vincristine (PCV) or temozolomide (TMZ) after biopsy, resection only, or wait-and-scan after biopsy.<br />Methods: Patients (n = 142) with molecularly defined oligodendroglioma (WHO 2016) were assigned to four cohorts: W&S, wait-and-scan after stereotactic biopsy (n = 59); RES, surgical resection only (n = 27); TMZ, temozolomide after biopsy (n = 26) or PCV (n = 30) after biopsy. Presurgical MRI T2 tumor volumes were obtained by manual segmentation. Progression-free survival (PFS), post-recurrence PFS (PR-PFS) and rate of histological progression to grade 3 were analyzed.<br />Results: PFS was longest after PCV (9.1 years), compared to 5.1 years after W&S, 4.4 years after RES and 3.6 years after TMZ. The rate of histological progression from grade 2 to 3 within 10 years was 9% for the PCV, 29% for the W&S, 67% for the RES and 75% for the TMZ group (p = 0.01). In the W&S group, patients treated with PCV at first relapse had a longer PFS from intervention than those treated with TMZ (7.2 vs 4.0 years, p = 0.04). Multivariate analysis identified smaller tumor volume prior to any intervention (p = 0.02) to be prognostic for PFS.<br />Conclusions: PCV chemotherapy alone is an effective treatment for WHO grade 2 oligodendroglioma, with long PFS and low rate of histological progression.
- Subjects :
- Antineoplastic Combined Chemotherapy Protocols therapeutic use
Humans
Lomustine therapeutic use
Neoplasm Staging
Procarbazine therapeutic use
Temozolomide therapeutic use
Vincristine
World Health Organization
Brain Neoplasms diagnostic imaging
Brain Neoplasms drug therapy
Oligodendroglioma diagnostic imaging
Oligodendroglioma drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1573-7373
- Volume :
- 153
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of neuro-oncology
- Publication Type :
- Academic Journal
- Accession number :
- 33932195
- Full Text :
- https://doi.org/10.1007/s11060-021-03765-z