PCV chemotherapy alone for WHO grade 2 oligodendroglioma: prolonged disease control with low risk of malignant progression.

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.

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.

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.

CONCLUSIONS:

PCV chemotherapy alone is an effective treatment for WHO grade 2 oligodendroglioma, with long PFS and low rate of histological progression.

• Authors: Jonathan Weller, Sophie Katzendobler, Philipp Karschnia, Stefanie Lietke, Rupert Egensperger, Niklas Thon, Michael Weller, Bogdana Suchorska, Joerg-Christian Tonn
• Journal: Journal of neuro-oncology (J Neurooncol) Vol. 153 Issue 2 Pg. 283-291 (Jun 2021) ISSN: 1573-7373 [Electronic] United States
• PMID: 33932195 (Publication Type: Journal Article)

Chemical References

• Procarbazine
• Vincristine
• Lomustine
• Temozolomide

Topics

• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Brain Neoplasms (diagnostic imaging, drug therapy)
• Humans
• Lomustine (therapeutic use)
• Neoplasm Staging
• Oligodendroglioma (diagnostic imaging, drug therapy)
• Procarbazine (therapeutic use)
• Temozolomide (therapeutic use)
• Vincristine
• World Health Organization