title: International retrospective study of over 1000 adults with anaplastic oligodendroglial tumors.
abstract: Treatment for newly diagnosed anaplastic oligodendroglial tumors is controversial. Radiotherapy (RT) alone and in combination with chemotherapy (CT) are the most well studied strategies. However, CT alone is often advocated, especially in cases with 1p19q codeletion. We retrospectively identified 1013 adults diagnosed from 1981-2007 treated initially with RT alone (n = 200), CT + RT (n = 528), CT alone (n = 201), or other strategies (n = 84). Median overall survival (OS) was 6.3 years and time to progression (TTP) was 3.1 years. 1p19q codeletion correlated with longer OS and TTP than no 1p or 19q deletion. In codeleted cases, median TTP was longer following CT + RT (7.2 y) than following CT (3.9 y, P = .003) or RT (2.5 y, P < .001) alone but without improved OS; median TTP was longer following treatment with PCV alone than temozolomide alone (7.6 vs. 3.3 y, P = .019). In cases with no deletion, median TTP was longer following CT + RT (3.1 y) than CT (0.9 y, P = .0124) or RT (1.1 y, P < .0001) alone; OS also favored CT + RT (median 5.0 y) over CT (2.2 y, P = .02) or RT (1.9 y, P < .0001) alone. In codeleted cases, CT alone did not appear to shorten OS in comparison with CT + RT, and PCV appeared to offer longer disease control than temozolomide but without a clear survival advantage. Combined CT + RT led to longer disease control and survival than did CT or RT alone in cases with no 1p19q deletion. Ongoing trials will address these issues prospectively.
authors.affiliation: Department of Neurology and Brain Tumor Center, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. lassmana@mskcc.org
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Lassman
authors.forename: Fabio M
authors.initials: FM
authors.lastname: Iwamoto
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Cloughesy
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Aldape
authors.forename: Andreana L
authors.initials: AL
authors.lastname: Rivera
authors.forename: April F
authors.initials: AF
authors.lastname: Eichler
authors.forename: David N
authors.initials: DN
authors.lastname: Louis
authors.forename: Nina A
authors.initials: NA
authors.lastname: Paleologos
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Fisher
authors.forename: Lynn S
authors.initials: LS
authors.lastname: Ashby
authors.forename: J Gregory
authors.initials: JG
authors.lastname: Cairncross
authors.forename: Gloria B
authors.initials: GB
authors.lastname: Roldán
authors.forename: Patrick Y
authors.initials: PY
authors.lastname: Wen
authors.forename: Keith L
authors.initials: KL
authors.lastname: Ligon
authors.forename: David
authors.initials: D
authors.lastname: Schiff
authors.forename: H Ian
authors.initials: HI
authors.lastname: Robins
authors.forename: Brandon G
authors.initials: BG
authors.lastname: Rocque
authors.forename: Marc C
authors.initials: MC
authors.lastname: Chamberlain
authors.forename: Warren P
authors.initials: WP
authors.lastname: Mason
authors.forename: Susan A
authors.initials: SA
authors.lastname: Weaver
authors.forename: Richard M
authors.initials: RM
authors.lastname: Green
authors.forename: Francois G
authors.initials: FG
authors.lastname: Kamar
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Abrey
authors.forename: Lisa M
authors.initials: LM
authors.lastname: DeAngelis
authors.forename: Suresh C
authors.initials: SC
authors.lastname: Jhanwar
authors.forename: Marc K
authors.initials: MK
authors.lastname: Rosenblum
authors.forename: Katherine S
authors.initials: KS
authors.lastname: Panageas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000628:therapy*; D002878:Chromosomes, Human, Pair 1 / Q000235:genetics*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007390:International Agencies; D008130:Lomustine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009837:Oligodendroglioma / Q000175:diagnosis / Q000235:genetics / Q000628:therapy*; D011344:Procarbazine / Q000008:administration & dosage; D011878:Radiotherapy; D012189:Retrospective Studies; D015996:Survival Rate; D000077204:Temozolomide; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D011344:Procarbazine; D014750:Vincristine; D008130:Lomustine; D003606:Dacarbazine; D000077204:Temozolomide