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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Initial treatment patterns over time for anaplastic oligodendroglial tumors
Katherine S Panageas1, Fabio M Iwamoto, Timothy F Cloughesy
1Department of Epidemiology & Biostatistics, Memorial Sloan-Kettering Cancer Center, 307 East 63rd Street, 3rd Floor, New York, NY 10021, USA. panageak@mskcc.org
Neuro-Oncology
|June 5, 2012
Summary
Treatment for anaplastic oligodendroglial tumors has shifted significantly, with chemotherapy (CT) alone becoming more common, especially for 1p19q codeleted tumors. Radiotherapy (RT) with temozolomide is now preferred for non-codeleted tumors.
Area of Science:
- Neuro-oncology
- Clinical neurology
- Cancer treatment research
Background:
- Anaplastic oligodendroglial tumors are rare brain neoplasms lacking a standardized treatment protocol.
- Treatment strategies have evolved over time, necessitating an analysis of historical patterns and influencing factors.
Purpose of the Study:
- To investigate temporal trends in treatment modalities for anaplastic oligodendroglial tumors.
- To identify clinical and molecular factors associated with specific treatment strategies.
- To inform future treatment guidelines for this rare cancer.
Main Methods:
- Retrospective analysis of an international cohort comprising 1013 patients diagnosed between 1981 and 2007.
- Evaluation of treatment patterns, including radiotherapy (RT) and chemotherapy (CT), over different time periods.
- Multivariate logistic regression to identify correlates of treatment selection, including 1p19q codeletion status and histology.
Main Results:
- Radiotherapy (RT) alone decreased significantly from 67% (1980-1984) to 5% (2005-2007).
- Chemotherapy (CT) alone increased from 0% to 38%, particularly in 1p19q codeleted tumors (57% in 2005-2007).
- Temozolomide largely replaced older chemotherapy regimens (PCV), and treatment choices significantly correlated with diagnosis date and 1p19q codeletion status.
Conclusions:
- Treatment for anaplastic oligodendroglial tumors has shifted towards chemotherapy, especially temozolomide, with distinct strategies emerging for 1p19q codeleted versus non-codeleted tumors.
- Diagnosis date, 1p19q codeletion status, histology, and tumor location are significant predictors of treatment received.
- Limited high-level evidence exists; ongoing clinical trials are crucial for establishing optimal therapeutic approaches.
