Introduction

Anaplastic oligodendrogliomas are high-grade gliomas defined molecularly by 1p19q co-deletion. There is no curative therapy, and standard of care includes surgical resection followed by radiation and chemotherapy. However, the benefit of up-front radiation with chemotherapy compared to chemotherapy alone has not been demonstrated in a randomized control trial. Given the potential long-term consequences of radiation therapy, such as cognitive impairment, arteriopathy, endocrinopathy, and hearing/visual impairment, there is an effort to balance longevity with radiation toxicity.

Methods

We performed a retrospective single institution analysis of survival of patients with anaplastic oligodendroglioma over 20 years.

Results

159 patients were identified as diagnosed with an anaplastic oligodendroglioma between 1996 and 2016. Of those, 40 patients were found to have AO at original diagnosis and had documented 1p19q co-deletion with a median of 7.1 years of follow-up (range: 0.6–16.7 years). After surgery, 45 % of patients were treated with radiation and chemotherapy at diagnosis, and 50 % were treated with adjuvant chemotherapy alone. The group treated with chemotherapy alone had a trend of receiving more cycles of chemotherapy than patients treated with radiation and chemotherapy upfront (p = 0.051). Median overall survival has not yet been reached. The related risk of progression in the upfront, adjuvant chemotherapy only group was almost 5-fold higher than the patients who received radiation and chemotherapy (hazard ratio = 4.85 (1.74–13.49), p = 0.002). However, there was no significant difference in overall survival in patients treated with upfront chemotherapy compared to patients treated upfront with chemotherapy and radiation (p = 0.8). Univariate analysis of age, KPS, extent of resection, or upfront versus delayed radiation was not associated with improved survival.

Conclusions

Initial treatment with adjuvant chemotherapy alone, rather than radiation and chemotherapy, may be an option for some patients with anaplastic oligodendroglioma, as it is associated with similar overall survival despite shorter progression free survival.

中文翻译：

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基于治疗范式的间变性少突胶质细胞瘤患者生存率的单一机构回顾性分析

介绍

间变性少突胶质细胞瘤是由 1p19q 共缺失分子定义的高级别胶质瘤。没有治愈性疗法，标准护理包括手术切除，然后是放疗和化疗。然而，与单独化疗相比，化疗的前期放疗的益处尚未在随机对照试验中得到证实。考虑到放射治疗的潜在长期后果，例如认知障碍、动脉病、内分泌病和听力/视力障碍，人们正在努力平衡长寿与放射毒性。

方法

我们对间变性少突胶质细胞瘤患者 20 年的生存情况进行了回顾性单一机构分析。

结果

1996 年至 2016 年间，159 名患者被确定为间变性少突胶质细胞瘤。其中 40 名患者在最初诊断时被发现患有 AO，并记录了 1p19q 共缺失，中位随访时间为 7.1 年（范围：0.6– 16.7 岁）。手术后，45% 的患者在确诊时接受了放疗和化疗，50% 的患者仅接受了辅助化疗。与预先接受放疗和化疗的患者相比，单独接受化疗的组有接受更多化疗周期的趋势（p = 0.051）。中位总生存期尚未达到。前期仅辅助化疗组的相关进展风险比接受放疗和化疗的患者高近 5 倍（风险比 = 4.85 (1.74–13.49)，p = 0.002）。然而，与接受化疗和放疗的患者相比，接受前期化疗的患者的总生存期没有显着差异（p = 0.8）。对年龄、KPS、切除范围或前期与延迟放疗的单变量分析与生存率提高无关。

结论

对于一些间变性少突胶质细胞瘤患者来说，单独的辅助化疗而不是放疗和化疗可能是一种选择，因为尽管无进展生存期较短，但它与相似的总生存期相关。