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Treatment of large low-grade oligodendroglial tumors with upfront procarbazine, lomustine, and vincristine chemotherapy with long follow-up: a retrospective cohort study with growth kinetics

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Abstract

We treated patients with newly diagnosed and large low-grade oligodendroglial tumors with upfront procarbazine, CCNU and vincristine (PCV) in order to delay radiotherapy. Patients were treated with PCV for a maximum of 6 cycles. The response to treatment was defined according to the RANO criteria; in addition change over time of mean tumor diameters (growth kinetics) was calculated. Thirty-two patients were treated between 1998 and 2006, 18 of which were diagnosed with 1p/19q co-deleted tumors. Median follow-up duration was 8 years (range 0.5–13 years). The median overall survival (mOS) was 120 months and the median progression-free survival (mPFS) was 46 months. Growth kinetics showed an ongoing decrease of the mean tumor diameter after completion of chemotherapy, during a median time of 35 months, but an increase of the mean tumor diameter did not herald progression as detected by RANO criteria. 1p/19q co-deletion was associated with a significant increase in OS (mOS 83 months versus not reached for codeleted tumors; p = 0.003)) and PFS (mPFS 35 months versus 67 months for codeleted tumors; p = 0.024). Patients with combined 1p/19q loss had a 10 year PFS of 34 % and the radiotherapy in these patients was postponed for a median period of more than 6 years. This long-term follow-up study indicates that upfront PCV chemotherapy is associated with long PFS and OS and delays radiotherapy for a considerable period of time in patients with low-grade oligodendroglial tumors, in particular with combined 1p/19q loss.

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Acknowledgments

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Conflict of interest

W.T., C.C.D., W.N.M.D., P.A.E.S.S., A.A.A.C.M.W., J.E.C.B. and I.H. report no disclosures. M.J.B. has served on the speakers’ bureau of MSD.

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Author notes

  1. Agnes A. A. C. M. Wertenbroek

    Present address: Department of Neurology, Ziekenhuis Groep Twente (ZGT), Zilvermeeuw 1, 7609 PP, Almelo, The Netherlands

Authors and Affiliations

  1. Department of Neuro-Oncology/Neurology, Erasmus MC Cancer Institute, Erasmus MC University Medical Center, Groene Hilledijk 301, 3075 EA, Rotterdam, The Netherlands

    Walter Taal, Peter A. E. Sillevis Smitt, Agnes A. A. C. M. Wertenbroek, Jacoline E. C. Bromberg, Irene van Heuvel & Martin J. van den Bent

  2. Department of Oncology, Erasmus MC Cancer Institute, Erasmus MC University Medical Center, Groene Hilledijk 301, 3075 EA, Rotterdam, The Netherlands

    Carin C. D. van der Rijt

  3. Department of Pathology, Josephine Nefkens Institute, Erasmus MC University Medical Center, Dr. Molewaterplein 50, 3015 GE, Rotterdam, The Netherlands

    Winand N. M. Dinjens & Johan M. Kros

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Taal, W., van der Rijt, C.C.D., Dinjens, W.N.M. et al. Treatment of large low-grade oligodendroglial tumors with upfront procarbazine, lomustine, and vincristine chemotherapy with long follow-up: a retrospective cohort study with growth kinetics. J Neurooncol 121, 365–372 (2015). https://doi.org/10.1007/s11060-014-1641-9

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