Initial treatment patterns over time for anaplastic oligodendroglial tumors.
Anaplastic oligodendroglial tumors are rare neoplasms with no standard approach to treatment. We sought to determine patterns of treatment delivered over time and identify clinical correlates of specific strategies using an international retrospective cohort of 1013 patients diagnosed from 1981-2007. Prior to 1990, most patients received radiotherapy (RT) alone as initial postoperative treatment. After 1990, approximately 50% of patients received both RT and chemotherapy (CT) sequentially and/or concurrently. Treatment with RT alone became significantly less common (67% in 1980-1984 vs 5% in 2005-2007, P < .0001). CT alone was more frequently administered in later years (0% in 1980-1984 vs 38% in 2005-2007; P < .0001), especially in patients with 1p19q codeleted tumors (57% of codeleted vs 4% with no deletion in 2005-2007; P < .0001). Temozolomide replaced the combination of procarbazine, lomustine, and vincristine (PCV) among patients who received CT alone or with RT (87% vs 2% in 2005-2007). In the most recent time period, patients with 1p19q codeleted tumors were significantly more likely to receive CT alone (with temozolomide), whereas RT with temozolomide was a significantly more common treatment strategy than either CT or RT alone in cases with no deletion (P < .0001). In a multivariate polytomous logistic regression model, the following were significantly associated with type of treatment delivered: date (5-year interval) of diagnosis (P < .0001), 1p19q codeletion (P < .0001), pure anaplastic oligodendroglioma histology (P < .01), and frontal lobe predominance (P < .05). Limited level 1 evidence is currently available to guide treatment decisions, and ongoing phase III trials will be critical to understanding the optimal therapy.
Department of Epidemiology & Biostatistics, Memorial Sloan-Kettering Cancer Center, 307 East 63rd Street, 3rd Floor, New York, NY 10021, USA. panageak@mskcc.org
Katherine S
KS
Panageas
Fabio M
FM
Iwamoto
Timothy F
TF
Cloughesy
Kenneth D
KD
Aldape
Andreana L
AL
Rivera
April F
AF
Eichler
David N
DN
Louis
Nina A
NA
Paleologos
Barbara J
BJ
Fisher
Lynn S
LS
Ashby
J Gregory
JG
Cairncross
Gloria B
GB
Roldán Urgoiti
Patrick Y
PY
Wen
Keith L
KL
Ligon
David
D
Schiff
H Ian
HI
Robins
Brandon G
BG
Rocque
Marc C
MC
Chamberlain
Warren P
WP
Mason
Susan A
SA
Weaver
Richard M
RM
Green
Francois G
FG
Kamar
Lauren E
LE
Abrey
Lisa M
LM
Deangelis
Suresh C
SC
Jhanwar
Marc K
MK
Rosenblum
Andrew B
AB
Lassman
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000235:genetics / Q000401:mortality / Q000628:therapy*; D059248:Chemoradiotherapy; D002878:Chromosomes, Human, Pair 1 / Q000235:genetics; D002888:Chromosomes, Human, Pair 19 / Q000235:genetics; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D017353:Gene Deletion; D006801:Humans; D007390:International Agencies; D008297:Male; D008875:Middle Aged; D009837:Oligodendroglioma / Q000235:genetics / Q000401:mortality / Q000628:therapy*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D015996:Survival Rate; D000077204:Temozolomide; D016896:Treatment Outcome; D055815:Young Adult
D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide