title: Glioblastoma multiforme with oligodendroglial component (GBMO): favorable outcome after post-operative radiotherapy and chemotherapy with nimustine (ACNU) and teniposide (VM26).
abstract: BACKGROUND
  The presence of an oligodendroglial component within a glioblastoma multiforme (GBM) is considered a prognostically favorable factor, but the clinical outcome of patients with glioblastoma multiforme with oligodendroglial component (GBMO) after combined post-operative radiotherapy and chemotherapy has rarely been reported.
  
  
  METHODS
  We analyzed overall and progression-free survival in a group of ten consecutive patients initially diagnosed with GBMO between 1996 and 2004 (4.2% of all GBM patients). Median (range) age was 54 (34-73) years, 90% were resected and median radiotherapy dose was 54 (45-60.6) Gy. 80% of patients received post-operative chemotherapy with nimustine (ACNU) and VM26 (teniposide) for a median of 3.5 (1-6) cycles, the remainder were treated with post-operative radiotherapy alone. All specimens were reviewed by an experienced neuropathologist.
  
  
  RESULTS
  Neuropathological re-evaluation revealed GBM with an oligodendroglial component of 30% or less in five cases, predominant oligoastrocytic tumors with focal areas of GBM in four patients and WHO grade III oligoastrocytoma with questionable transition to GBM in one patient. Four of ten patients were alive at at 40, 41, 41 and 82 months. The median overall survival (Kaplan-Meier) was 26 months, the 2-year survival rate was 60% (progression-free survival: 9.8 months and 40%, respectively).
  
  
  CONCLUSIONS
  In conclusion, patients with GBMO treated with post-operative radiotherapy and chemotherapy with ACNU/VM26 had a better prognosis than reported for GBM in modern chemoradiation series.
authors.affiliation: Dept. of Radiation Oncology, University of Würzburg, Würzburg, Germany. vordermark_d@klinik.uni-wuerzburg.de
authors.forename: Dirk
authors.initials: D
authors.lastname: Vordermark
authors.forename: Klemens
authors.initials: K
authors.lastname: Ruprecht
authors.forename: Peter
authors.initials: P
authors.lastname: Rieckmann
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Roggendorf
authors.forename: Giles H
authors.initials: GH
authors.lastname: Vince
authors.forename: Monika
authors.initials: M
authors.lastname: Warmuth-Metz
authors.forename: Oliver
authors.initials: O
authors.lastname: Kölbl
authors.forename: Michael
authors.initials: M
authors.lastname: Flentje
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003399:Craniotomy; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D015376:Nimustine / Q000008:administration & dosage; D009836:Oligodendroglia / Q000473:pathology; D009837:Oligodendroglioma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D016019:Survival Analysis; D013713:Teniposide / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D015376:Nimustine; D013713:Teniposide