Abstract:
:Combination of procarbazine, lomustine and vincristine (PCV) with radiation therapy (RT) has been associated with longer survival in patients with anaplastic oligodendroglioma (AO) and anaplastic oligoastrocytoma (AOA), especially in those with chromosome 1p/19q codeletion. We report a multicenter retrospective study of 84 consecutive adult patients with AO and AOA treated with RT plus concomitant and adjuvant temozolomide (TMZ) between February 2004 and January 2011. Correlations between chromosome 1p/19q codeletion, isocitrate dehydrogenase1 (IDH1) mutation, and O-6-methylguanine-DNA methyltransferase (MGMT) promoter methylation with survival outcomes have been analyzed. For all 84 patients the median overall survival (OS) and progression-free survival rates were 55.6 and 45.2 months, respectively. Grade 3 or 4 hematological toxicity occurred in 17 % of patients. Chromosome 1p/19q codeletion was detected in 57 %, IDH1 mutation in 63 %, and MGMT promoter methylation in 74 % of evaluable patients. In multivariate analysis the presence of chromosome 1p/19q codeletion was associated with significant survival benefit (median OS 34 months in noncodeleted tumors and not reached in codeleted tumors; HR 0.16, 95 % CI 0.03-0.45; P = 0.005). IDH1 mutation was also of prognostic significance for longer survival (P = 0.001; HR 0.20, 95 % 0.06-0.41), whereas MGMT promoter methylation was only of borderline significance. The study indicates that RT with concomitant and adjuvant TMZ is a relatively safe treatment associated with longer survival in patients with 1p/19q codeleted and IDH1 mutated tumors. Results from ongoing randomized studies will be essential to clarify if RT plus TMZ may provide survival as good as or better than RT combined with PCV for patients with AO and AOA.
journal_name
J Neurooncoljournal_title
Journal of neuro-oncologyauthors
Minniti G,Arcella A,Scaringi C,Lanzetta G,Di Stefano D,Scarpino S,Pace A,Giangaspero F,Osti MF,Enrici RMdoi
10.1007/s11060-013-1288-ysubject
Has Abstractpub_date
2014-01-01 00:00:00pages
275-82issue
2eissn
0167-594Xissn
1573-7373journal_volume
116pub_type
杂志文章,多中心研究abstract:PURPOSE:The highly vascular malignant brain tumor glioblastoma (GBM) appears to be an ideal target for anti-angiogenic therapy; however, clinical trials to date suggest the VEGF antibody bevacizumab affects only progression-free survival. Here we analyze a group of patients with GBM who received bevacizumab treatment a...
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更新日期:1999-01-01 00:00:00
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abstract:BACKGROUND:The diagnosis of sarcomatous transformation of plexiform neurofibromas in Neurofibromatosis-1 (NF 1) is a clinical and radiological challenge. Considerable overlap exists in the clinical and the radiological characteristics between the benign enlarging neurofibromas and their counterparts undergoing malignan...
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journal_title:Journal of neuro-oncology
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journal_title:Journal of neuro-oncology
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