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Radiotherapy plus temozolomide or PCV in patients with anaplastic oligodendroglioma 1p19q codeleted
A Gonzalez-Aguilar1,2, I Reyes-Moreno1,2, R P Peiro-Osuna1
1Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico DF, Mexico.
Revista De Neurologia
|October 6, 2018
Summary
Procarbazine, lomustine, and vincristine (PCV) chemotherapy shows superior survival outcomes compared to temozolomide for anaplastic oligodendroglioma 1p19q codeleted tumors. PCV offers better progression-free and overall survival despite higher toxicity.
Area of Science:
- Neuro-oncology
- Radiation Oncology
- Medical Oncology
Background:
- Anaplastic oligodendroglioma with 1p19q codeletion is a distinct molecular subtype.
- Radiotherapy combined with chemotherapy is a standard treatment approach.
- Procarbazine, lomustine, and vincristine (PCV) has demonstrated efficacy in this patient population.
Purpose of the Study:
- To compare the efficacy and safety of radiotherapy plus temozolomide versus radiotherapy plus procarbazine, lomustine, and vincristine (PCV) in patients with 1p19q codeleted anaplastic oligodendroglioma.
- To evaluate overall survival, progression-free survival, and radiological response between the two treatment protocols.
Main Methods:
- Retrospective analysis of 48 patients with 1p19q codeleted anaplastic oligodendroglioma.
- Comparison of outcomes between patients treated with radiotherapy plus temozolomide and those treated with radiotherapy plus PCV.
- Primary endpoints: overall survival and progression-free survival. Secondary endpoint: radiological response.
Main Results:
- The procarbazine, lomustine, and vincristine (PCV) group demonstrated significantly longer progression-free survival (7.2 years) and overall survival (10.6 years) compared to the temozolomide group (6.1 and 9.2 years, respectively).
- Radiological response rates were high in both groups (80.9% for PCV, 70.2% for temozolomide) without statistical difference.
- Higher rates of grade 3 or 4 toxicity were observed in the PCV arm (42.8%) compared to the temozolomide arm (11.1%).
Conclusions:
- Radiotherapy with procarbazine, lomustine, and vincristine (PCV) is more effective than temozolomide in improving survival for anaplastic oligodendroglioma with 1p19q codeletion.
- Despite higher toxicity, PCV demonstrates superior efficacy, supporting its use as a first-line treatment.
- Efforts are needed to ensure the availability of PCV in regions like Latin America for optimal patient care.
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