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Retrospective analysis of treatment outcome in 315 patients with oligodendroglial brain tumors.

Vesper J, Graf E, Wille C, Tilgner J, Trippel M, Nikkhah G, Ostertag C - BMC Neurol (2009)

Bottom Line: Multivariate analysis adjusting for prognostic imbalances favouring the PC group showed a minor, statistically non-significant benefit for PCV (hazard ratio 0.81, 95% confidence interval 0.53-1.25; p = 0.346).Younger age (< 50 y) was a statistically significant predictor of longer PFS.Significant advantages in terms of overall survival after first diagnosis of oligodendroglial tumor (OS, n = 315) were found for patients < 50 y (p < 0.001), oligodendrogliomas versus oligoastrocytomas (p = 0.002), and WHO degrees II vs. degrees III (p < 0.001).

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Affiliation: Department of Functional Neurosurgery, Neurosurgical Clinic, Heinrich-Heine University Duesseldorf, Germany. jan.vesper@uniklinik-duesseldorf.de

ABSTRACT
Although chemotherapy with procarbazine, lomustine and vincristine (PCV) is considered to be well tolerated, side effects frequently lead to dose reduction or even discontinuation of treatment of oligodendroglial brain tumors. The primary objective of the analysis was to retrospectively compare progression-free survival (PFS) after PCV vs. PC chemotherapy (without vincristine to avoid side effects). Patients were retrospectively identified from a database containing our patients between 1990 and 2003. For the selected cases, all histopathology reports were re-evaluated by a local neuropathologist. Based on the updated histology data, patients were included in the study if they had at least one histological diagnosis of an oligodendroglial tumor. PFS after start of PCV (n = 61) and PC (n = 84) chemotherapy identical (median 30 months). Multivariate analysis adjusting for prognostic imbalances favouring the PC group showed a minor, statistically non-significant benefit for PCV (hazard ratio 0.81, 95% confidence interval 0.53-1.25; p = 0.346). Younger age (< 50 y) was a statistically significant predictor of longer PFS. Significant advantages in terms of overall survival after first diagnosis of oligodendroglial tumor (OS, n = 315) were found for patients < 50 y (p < 0.001), oligodendrogliomas versus oligoastrocytomas (p = 0.002), and WHO degrees II vs. degrees III (p < 0.001). Three risk groups regarding OS were identified. Findings support the hypothesis that PC may be as effective as PCV chemotherapy, while avoiding the additional risks of vincristine. Younger age, lower tumor grade and histology of an oligodendroglioma were identified to be favorable prognostic factors.

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Overall survival after first diagnosis of oligodendroglioma or oligoastrocytoma (n = 315) by risk group (low, medium, high risk).
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Figure 3: Overall survival after first diagnosis of oligodendroglioma or oligoastrocytoma (n = 315) by risk group (low, medium, high risk).

Mentions: In the entire population of 315 patients, 120 deaths occurred during a median follow-up period of 7 years for OS after first diagnosis of oligodendroglial tumor. 88%, 77%, 67%, 63% and 52% of patients survived for more than 2, 4, 6, 8, and 10 years, respectively. Young age, oligodendroglioma and WHO grade II showed large and statistically significant favorable effects on OS, while no relevant influence could be demonstrated for resection (Table 4). Three groups of patients were identified as low, medium and high risk groups. Patients aged under 50 with oligoastrocytoma of WHO grade II and no resection constituted the largest group (n = 122) with medium risk. Those either aged ≥ 50 or aged under 50 with WHO grade III tumors were at high risk (n = 105). Patients were at low risk if they were aged under 50, had a WHO grade II tumor and either a previous resection or oligoastrocytoma but no previous resection (n = 88, Figure 3).


Retrospective analysis of treatment outcome in 315 patients with oligodendroglial brain tumors.

Vesper J, Graf E, Wille C, Tilgner J, Trippel M, Nikkhah G, Ostertag C - BMC Neurol (2009)

Overall survival after first diagnosis of oligodendroglioma or oligoastrocytoma (n = 315) by risk group (low, medium, high risk).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2719586&req=5

Figure 3: Overall survival after first diagnosis of oligodendroglioma or oligoastrocytoma (n = 315) by risk group (low, medium, high risk).
Mentions: In the entire population of 315 patients, 120 deaths occurred during a median follow-up period of 7 years for OS after first diagnosis of oligodendroglial tumor. 88%, 77%, 67%, 63% and 52% of patients survived for more than 2, 4, 6, 8, and 10 years, respectively. Young age, oligodendroglioma and WHO grade II showed large and statistically significant favorable effects on OS, while no relevant influence could be demonstrated for resection (Table 4). Three groups of patients were identified as low, medium and high risk groups. Patients aged under 50 with oligoastrocytoma of WHO grade II and no resection constituted the largest group (n = 122) with medium risk. Those either aged ≥ 50 or aged under 50 with WHO grade III tumors were at high risk (n = 105). Patients were at low risk if they were aged under 50, had a WHO grade II tumor and either a previous resection or oligoastrocytoma but no previous resection (n = 88, Figure 3).

Bottom Line: Multivariate analysis adjusting for prognostic imbalances favouring the PC group showed a minor, statistically non-significant benefit for PCV (hazard ratio 0.81, 95% confidence interval 0.53-1.25; p = 0.346).Younger age (< 50 y) was a statistically significant predictor of longer PFS.Significant advantages in terms of overall survival after first diagnosis of oligodendroglial tumor (OS, n = 315) were found for patients < 50 y (p < 0.001), oligodendrogliomas versus oligoastrocytomas (p = 0.002), and WHO degrees II vs. degrees III (p < 0.001).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Functional Neurosurgery, Neurosurgical Clinic, Heinrich-Heine University Duesseldorf, Germany. jan.vesper@uniklinik-duesseldorf.de

ABSTRACT
Although chemotherapy with procarbazine, lomustine and vincristine (PCV) is considered to be well tolerated, side effects frequently lead to dose reduction or even discontinuation of treatment of oligodendroglial brain tumors. The primary objective of the analysis was to retrospectively compare progression-free survival (PFS) after PCV vs. PC chemotherapy (without vincristine to avoid side effects). Patients were retrospectively identified from a database containing our patients between 1990 and 2003. For the selected cases, all histopathology reports were re-evaluated by a local neuropathologist. Based on the updated histology data, patients were included in the study if they had at least one histological diagnosis of an oligodendroglial tumor. PFS after start of PCV (n = 61) and PC (n = 84) chemotherapy identical (median 30 months). Multivariate analysis adjusting for prognostic imbalances favouring the PC group showed a minor, statistically non-significant benefit for PCV (hazard ratio 0.81, 95% confidence interval 0.53-1.25; p = 0.346). Younger age (< 50 y) was a statistically significant predictor of longer PFS. Significant advantages in terms of overall survival after first diagnosis of oligodendroglial tumor (OS, n = 315) were found for patients < 50 y (p < 0.001), oligodendrogliomas versus oligoastrocytomas (p = 0.002), and WHO degrees II vs. degrees III (p < 0.001). Three risk groups regarding OS were identified. Findings support the hypothesis that PC may be as effective as PCV chemotherapy, while avoiding the additional risks of vincristine. Younger age, lower tumor grade and histology of an oligodendroglioma were identified to be favorable prognostic factors.

Show MeSH
Related in: MedlinePlus