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Multicenter Study
. 2011 Jun;13(6):649-59.
doi: 10.1093/neuonc/nor040.

International retrospective study of over 1000 adults with anaplastic oligodendroglial tumors

Andrew B Lassman  1 , Fabio M Iwamoto, Timothy F Cloughesy, Kenneth D Aldape, Andreana L Rivera, April F Eichler, David N Louis, Nina A Paleologos, Barbara J Fisher, Lynn S Ashby, J Gregory Cairncross, Gloria B Roldán, Patrick Y Wen, Keith L Ligon, David Schiff, H Ian Robins, Brandon G Rocque, Marc C Chamberlain, Warren P Mason, Susan A Weaver, Richard M Green, Francois G Kamar, Lauren E Abrey, Lisa M DeAngelis, Suresh C Jhanwar, Marc K Rosenblum, Katherine S Panageas
Affiliations
Multicenter Study

International retrospective study of over 1000 adults with anaplastic oligodendroglial tumors

Andrew B Lassman et al. Neuro Oncol. 2011 Jun.

Abstract

Treatment for newly diagnosed anaplastic oligodendroglial tumors is controversial. Radiotherapy (RT) alone and in combination with chemotherapy (CT) are the most well studied strategies. However, CT alone is often advocated, especially in cases with 1p19q codeletion. We retrospectively identified 1013 adults diagnosed from 1981-2007 treated initially with RT alone (n = 200), CT + RT (n = 528), CT alone (n = 201), or other strategies (n = 84). Median overall survival (OS) was 6.3 years and time to progression (TTP) was 3.1 years. 1p19q codeletion correlated with longer OS and TTP than no 1p or 19q deletion. In codeleted cases, median TTP was longer following CT + RT (7.2 y) than following CT (3.9 y, P = .003) or RT (2.5 y, P < .001) alone but without improved OS; median TTP was longer following treatment with PCV alone than temozolomide alone (7.6 vs. 3.3 y, P = .019). In cases with no deletion, median TTP was longer following CT + RT (3.1 y) than CT (0.9 y, P = .0124) or RT (1.1 y, P < .0001) alone; OS also favored CT + RT (median 5.0 y) over CT (2.2 y, P = .02) or RT (1.9 y, P < .0001) alone. In codeleted cases, CT alone did not appear to shorten OS in comparison with CT + RT, and PCV appeared to offer longer disease control than temozolomide but without a clear survival advantage. Combined CT + RT led to longer disease control and survival than did CT or RT alone in cases with no 1p19q deletion. Ongoing trials will address these issues prospectively.

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Figures

Fig. 1.
Fig. 1.
Kaplan–Meier estimates of overall survival (A) and time to progression (B) by initial treatment with chemotherapy (CT) alone, radiotherapy (RT) alone, or CT + RT combined (concurrently and/or sequentially).
Fig. 2.
Fig. 2.
Kaplan–Meier estimates of overall survival (A) and time to progression (B) for patients with tumors harboring 1p and 19q deletion (codeletion) or neither 1p nor 19q deletion (no deletion).
Fig. 3.
Fig. 3.
Kaplan–Meier estimates of overall survival (A and C) and time to progression (B and D) by initial treatment (CT alone, RT alone, or CT + RT) and deletion status.
Fig. 4.
Fig. 4.
Kaplan–Meier estimates of overall survival (A) and time to progression (B) in codeleted cases treated initially with either PCV or TMZ alone.
See this image and copyright information in PMC

Comment in

  • In regard to Lassman et al.
    Weltman E, Fleury Malheiros SM. Weltman E, et al. Neuro Oncol. 2012 Jun;14(6):676; author reply 677-8. doi: 10.1093/neuonc/nos127. Neuro Oncol. 2012. PMID: 22669104 Free PMC article. No abstract available.

References

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