Anaplastic oligodendroglioma responding favorably to intranasal delivery of perillyl alcohol: a case report and literature review.
BACKGROUND
In recent years, molecular genetics and biology are exerting significant influence on the practice of neuro-oncology, with oligodendrogliomas being the most prominent example. To explore therapeutic strategies and evaluate the clinical results, we report a case of a patient with anaplastic oligodendroglioma managed with intranasal delivery of POH.


METHODS
A 62 year-old white woman presented with complaints of seizures and frontal headache in June 1999. Nervous system examination was normal. Her Karnofsky performance score was 90. A contrast-enhanced MRI scan of the brain revealed a regular space-occupying lesion in the right frontal lobe that enhanced with gadolinium. A radical surgical excision of the tumor was carried out, and the histopathological diagnosis was an anaplastic oligodendroglioma. Subsequently, there were 2 recurrent/progressive lesions, in July 2002 and October 2004, despite combination treatment using surgery, radiotherapy, and chemotherapy. Intranasal delivery of 0.3% concentration of POH 4 times daily was performed. A follow-up MRI scan after 5 months of treatment revealed reduction in size of the enhancing lesion.


CONCLUSIONS
Whereas surgery continues to be the primary treatment for oligodendroglioma, the scheme for postoperative therapy has shifted primarily because of the lesion's relative chemosensitivity. This article evaluates the effects of intranasal delivery of POH in a case of regression of anaplastic oligodendroglioma.
Da Fonseca
Clovis O
CO
Serviço de Neurocirurgia, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, 24030-210 Niterói, RJ, Brazil. clovis.orlando@uol.com.br
Masini
Marcos
M
Futuro
Débora
D
Caetano
Regina
R
Gattass
Cerli Rocha
CR
Quirico-Santos
Thereza
T
D000280:Administration, Inhalation; D000281:Administration, Intranasal; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D006801:Humans; D017567:Karnofsky Performance Status; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D039821:Monoterpenes / Q000008:administration & dosage / Q000627:therapeutic use*; D009837:Oligodendroglioma / Q000188:drug therapy* / Q000473:pathology* / Q000628:therapy; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D039821:Monoterpenes; C032208:perillyl alcohol