title: A phase II study of intensified chemotherapy alone as initial treatment for newly diagnosed anaplastic oligodendroglioma: an interim analysis.
abstract: BACKGROUND
  Anaplastic oligodendrogliomas (AO) and anaplastic oligoastrocytomas (AOA) are currently treated with a combination of surgery, radiotherapy and chemotherapy. Myeloablative therapy with autologous peripheral blood progenitor cell rescue (APBPCR) is one strategy to exploit the chemosensitivity of these tumors while deferring cranial radiation in an effort to avoid radiation-related neurotoxicity.
  
  
  METHODS
  Twenty patients (16 AO, 4 AOA) with a median age of 46 years (range, 19-60) and KPS of 90 (range, 70-100) were treated with 4 cycles of procarbazine, Lomustine (CCNU) and vincristine (I-PCV) every six weeks. Responding patients were eligible for myeloablative therapy with busulfan and thiotepa followed by APBPCR. 1p and 19q chromosomes were analyzed prospectively but patients were enrolled without regard to deletion status.
  
  
  RESULTS
  Fifteen patients (75%) had a response to I-PCV and 14 underwent transplant. Median disease-free and overall survival of the transplanted patients has not been reached but is at least 36 months. No patients required dose reduction or termination of I-PCV due to toxicity. Hepatic veno-occlusive disease (VOD) was a complication of transplant in three patients and resulted in one death. Patients with and without deletions of 1p and 19q had durable responses.
  
  
  CONCLUSIONS
  This regimen conferred durable responses in more than one-half of patients, allowing deferral of radiotherapy for three years or longer. The major limitation of this approach is the acute toxicity associated with both the induction and consolidation regimens; temozolomide has replaced I-PCV for the current trial and the incidence and severity of VOD is being followed closely.
authors.affiliation: Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10021, USA.
authors.forename: Nimish A
authors.initials: NA
authors.lastname: Mohile
authors.forename: Peter
authors.initials: P
authors.lastname: Forsyth
authors.forename: Douglas
authors.initials: D
authors.lastname: Stewart
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Raizer
authors.forename: Nina
authors.initials: N
authors.lastname: Paleologos
authors.forename: Tarun
authors.initials: T
authors.lastname: Kewalramani
authors.forename: David N
authors.initials: DN
authors.lastname: Louis
authors.forename: J Gregory
authors.initials: JG
authors.lastname: Cairncross
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Abrey
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001254:Astrocytoma / Q000628:therapy*; D001932:Brain Neoplasms / Q000628:therapy*; D002066:Busulfan / Q000008:administration & dosage; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017567:Karnofsky Performance Status; D008130:Lomustine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009837:Oligodendroglioma / Q000628:therapy*; D011344:Procarbazine / Q000008:administration & dosage; D018714:Radiotherapy, Adjuvant / Q000379:methods*; D012189:Retrospective Studies; D016019:Survival Analysis; D013852:Thiotepa / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D011344:Procarbazine; D014750:Vincristine; D008130:Lomustine; D013852:Thiotepa; D002066:Busulfan