Initial treatment patterns over time for anaplastic oligodendroglial tumors

Anaplastic oligodendroglial tumors are rare neoplasms with no standard approach to treatment. We sought to determine patterns of treatment delivered over time and identify clinical correlates of specific strategies using an international retrospective cohort of 1013 patients diagnosed from 1981-2007...

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Bibliographic Details
Published in:Neuro-oncology (Charlottesville, Va.) Va.), 2012-06, Vol.14 (6), p.761-767
Main Authors: Panageas, Katherine S, Iwamoto, Fabio M, Cloughesy, Timothy F, Aldape, Kenneth D, Rivera, Andreana L, Eichler, April F, Louis, David N, Paleologos, Nina A, Fisher, Barbara J, Ashby, Lynn S, Cairncross, J Gregory, Roldán Urgoiti, Gloria B, Wen, Patrick Y, Ligon, Keith L, Schiff, David, Robins, H Ian, Rocque, Brandon G, Chamberlain, Marc C, Mason, Warren P, Weaver, Susan A, Green, Richard M, Kamar, Francois G, Abrey, Lauren E, Deangelis, Lisa M, Jhanwar, Suresh C, Rosenblum, Marc K, Lassman, Andrew B
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Antineoplastic Agents, Alkylating - therapeutic use
Brain Neoplasms - genetics
Brain Neoplasms - mortality
Brain Neoplasms - therapy
Chemoradiotherapy
Chromosomes, Human, Pair 1 - genetics
Chromosomes, Human, Pair 19 - genetics
Clinical Investigations
Dacarbazine - analogs & derivatives
Dacarbazine - therapeutic use
Female
Follow-Up Studies
Gene Deletion
Humans
International Agencies
Male
Middle Aged
Oligodendroglioma - genetics
Oligodendroglioma - mortality
Oligodendroglioma - therapy
Radiotherapy Dosage
Retrospective Studies
Survival Rate
Treatment Outcome
Young Adult
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Summary:Anaplastic oligodendroglial tumors are rare neoplasms with no standard approach to treatment. We sought to determine patterns of treatment delivered over time and identify clinical correlates of specific strategies using an international retrospective cohort of 1013 patients diagnosed from 1981-2007. Prior to 1990, most patients received radiotherapy (RT) alone as initial postoperative treatment. After 1990, approximately 50% of patients received both RT and chemotherapy (CT) sequentially and/or concurrently. Treatment with RT alone became significantly less common (67% in 1980-1984 vs 5% in 2005-2007, P < .0001). CT alone was more frequently administered in later years (0% in 1980-1984 vs 38% in 2005-2007; P < .0001), especially in patients with 1p19q codeleted tumors (57% of codeleted vs 4% with no deletion in 2005-2007; P < .0001). Temozolomide replaced the combination of procarbazine, lomustine, and vincristine (PCV) among patients who received CT alone or with RT (87% vs 2% in 2005-2007). In the most recent time period, patients with 1p19q codeleted tumors were significantly more likely to receive CT alone (with temozolomide), whereas RT with temozolomide was a significantly more common treatment strategy than either CT or RT alone in cases with no deletion (P < .0001). In a multivariate polytomous logistic regression model, the following were significantly associated with type of treatment delivered: date (5-year interval) of diagnosis (P < .0001), 1p19q codeletion (P < .0001), pure anaplastic oligodendroglioma histology (P < .01), and frontal lobe predominance (P < .05). Limited level 1 evidence is currently available to guide treatment decisions, and ongoing phase III trials will be critical to understanding the optimal therapy.
ISSN:1522-8517
1523-5866
DOI:10.1093/neuonc/nos065