Conformal irradiation for pure and mixed oligodendroglioma: the experience of Centre Leon Berard Lyon.
OBJECTIVE
To assess whether conformal radiotherapy (CRT) after incomplete surgery or biopsy for pure oligodendrogliomas and mixed gliomas results in decreased long-term sequelae without impairing local control and while reducing irradiated volume.


METHODS
Twenty-six consecutive patients who presented with pure (21) or mixed (5) oligodendrogliomas and who were given incomplete resections were treated according 3 different strategies: CRT alone (12), chemotherapy followed by CRT (4), and chemotherapy and delayed CRT at the time of tumor progression (10). CRT consisted of multiple noncoplanar fields. Median dose was 60 Gy. Quality of CRT was assessed using tumor and normal tissue conformal indexes. The location of recurrences was assessed with MRI and dosimetric data. Late sequelae were assessed by a questionnaire exploring professional outcome, and also by a Mini Mental State Examination test.


RESULTS
The mean overall survival was 5.2 years. Fifteen patients experienced a local relapse. All but 1 occurred in the 95% isodose. Among 11 nonevolutive patients, 6 have a full-time or part-time job.


CONCLUSIONS
Despite CRT, infield recurrence was a common feature in patients with oligodendrogliomas and mixed tumors. Further research, including molecular biology typing of tumors and type of treatment, is warranted to improve survival and quality of life.
Sunyach
M P
MP
Department of Radiotherapy, Centre Leon Berard, Lyon, France. SUNYACH@lyon.fnclcc.fr
Pommier
P
P
Martel Lafay
I
I
Guyotat
J
J
Ginestet
G
G
Jouanneau
E
E
Jouvet
A
A
Sindou
M
M
Bret
P
P
Carrie
C
C
Frappaz
D
D
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D001925:Brain Damage, Chronic / Q000209:etiology; D001930:Brain Injuries / Q000209:etiology; D001932:Brain Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000523:psychology / Q000532:radiotherapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018450:Disease Progression; D018572:Disease-Free Survival; D004651:Employment; D005260:Female; D005602:France / Q000453:epidemiology; D005910:Glioma / Q000188:drug therapy / Q000401:mortality / Q000523:psychology / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D015993:Life Tables; D008130:Lomustine; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009837:Oligodendroglioma / Q000188:drug therapy / Q000401:mortality / Q000523:psychology / Q000532:radiotherapy* / Q000601:surgery; D011344:Procarbazine; D011581:Psychological Tests; D011788:Quality of Life; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000706:statistics & numerical data; D012917:Social Adjustment; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D014750:Vincristine
D011344:Procarbazine; D014750:Vincristine; D008130:Lomustine