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Oligodendroglial Tumors

Note: Some citations in the text of this section are followed by a level of evidence. The PDQ editorial boards use a formal ranking system to help the reader judge the strength of evidence linked to the reported results of a therapeutic strategy. (Refer to the PDQ summary on Levels of Evidence for more information.)

Oligodendroglial

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Oligodendrogliomas (World Health Organization grade II) behave like diffuse astrocytomas. (Refer to the Oligodendroglial Tumors section in the Classification section of this summary for more information.)

Standard treatment options:

  • Surgery plus radiation therapy; however, some controversy exists concerning the timing of radiation therapy. A study (EORTC-22845) of 300 patients who had surgery were randomized to either radiation therapy or watch and wait.[1] There was no difference in overall survival (OS) in the two groups.[1][Level of evidence: 1iiA] Median progression-free survival was 5.3 years in the radiation therapy group and 3.4 years in the control group.[1][Level of evidence: 1iiDiii]

Treatment options under clinical evaluation:

  1. Clinical trials are evaluating the effect of adding drugs to local therapy, e.g., radiation therapy with or without chemotherapy for incompletely resected tumors.
  2. Chemotherapy. Temozolomide appears to have activity in patients with low-grade oligodendrogliomas with a 1p allelic loss. Clinical improvement was noted in 51% of patients, and the radiologic response rate was 31%.[2][Level of evidence: 3iiiDiv]
  3. Patients with newly diagnosed and recurrent low-grade oligodendrogliomas and oligoastrocytomas respond to procarbazine, lomustine, and vincristine (PCV) therapy. In 3 of 5 patients recurrent disease was found, and 13 of 16 newly diagnosed patients responded to PCV. Median time to progression was 24 months.[3][Level of evidence: 3iiiDiv]

Anaplastic Oligodendroglioma

Anaplastic oligodendrogliomas (WHO grade III) have a low cure rate with standard local treatment.[4] These patients are appropriate candidates for clinical trials designed to improve local control by adding newer forms of treatment. (Refer to the Oligodendroglial Tumors section in the Classification section of this summary for more information.)

Standard treatment options:

  1. Surgery plus radiation therapy.[5,6,7,8]
  2. Surgery plus radiation therapy plus chemotherapy.[9,10]
  3. Patients with an allelic loss at 1p and 19q have a higher than average response rate to PCV chemotherapy.[11,12][Level of evidence: 3iiiDiv]
  4. A recent phase III study compared radiation therapy alone with chemotherapy plus radiation therapy. Progression-free survival was increased but overall survival was not.[13][Level of evidence: 1iiDiii] This was true in the 1p and 19q allelic deletion group as well. These studies are ongoing.

Treatment options under clinical evaluation:

  • Patients with brain tumors that are either infrequently curable or unresectable should be considered candidates for clinical trials.

Current Clinical Trials

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with adult oligodendroglial tumors. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.

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WebMD Public Information from the National Cancer Institute

Last Updated: October 07, 2011
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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