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01-07-2021 | Glioma | Clinical Study

A single institution retrospective analysis on survival based on treatment paradigms for patients with anaplastic oligodendroglioma

Authors: Nancy Ann Oberheim Bush, Jacob S. Young, Yalan Zhang, Cecilia L. Dalle Ore, Annette M. Molinaro, Jennie Taylor, Jennifer Clarke, Michael Prados, Steve E. Braunstein, David R. Raleigh, Susan M. Chang, Mitchel S. Berger, Nicholas A. Butowski

Published in: Journal of Neuro-Oncology | Issue 3/2021

Abstract

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.

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Title: A single institution retrospective analysis on survival based on treatment paradigms for patients with anaplastic oligodendroglioma
Authors: Nancy Ann Oberheim Bush
Jacob S. Young
Yalan Zhang
Cecilia L. Dalle Ore
Annette M. Molinaro
Jennie Taylor
Jennifer Clarke
Michael Prados
Steve E. Braunstein
David R. Raleigh
Susan M. Chang
Mitchel S. Berger
Nicholas A. Butowski
Publication date: 01-07-2021
Publisher: Springer US
Keywords: Glioma
Glioma
Oligodendroglioma
Glioma
Cytostatic Therapy
Published in: Journal of Neuro-Oncology / Issue 3/2021
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-021-03781-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A single institution retrospective analysis on survival based on treatment paradigms for patients with anaplastic oligodendroglioma

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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