© 2005-2012 American Society of Clinical Oncology (ASCO). All rights reserved worldwide.
June 6, 2004
Anaplastic oligodendrogliomas (AOs) and anaplastic oligoastrocytomas (AOAs) are rare but fast-growing tumors that develop in the brain. The standard treatment is surgery followed by radiation. Doctors also know that these tumors respond to a chemotherapy regimen called PCV (procarbazine, lomustine, and vincristine). This study was done to find out whether giving PCV before radiation treatment improved survival in people with AOs and AOAs.
The results showed that overall survival was not different between the patients who received chemotherapy before radiation (4.8 years) and those who received only radiation (4.5 years). However, the cancer took longer to progress in the patients who received both chemotherapy and radiation (2.6 years) compared with the patients who only received radiation (1.9 years). The combination treatment, though, was more toxic than radiation alone.
Doctors also collected tissue samples from the tumors, knowing that in the past, oligodendrogliomas with a certain genetic characteristic responded better to treatment than tumors without it. Interestingly, the patients with oligodendrogliomas that had this genetic feature lived longer, regardless of the treatment they received.
"Oligodendrogliomas with this genetic signature have a better natural history and response to treatment. Oncologists can learn to use this information to choose the most appropriate treatment for these patients," said J. Gregory Cairncross, MD, lead author and Professor of Clinical Neuroscience and Oncology at the University of Calgary in Canada.
While longer follow-up is needed to learn whether there are any longer-term differences in treatment, this study suggests that, in the future, doctors will be able to use genetic markers to assess the prognosis (chance of recovery) of patients with oligodendrogliomas.
What This Means For Patients
These findings show that treating patients with both radiation and chemotherapy keeps the cancer from progressing longer than treatment with radiation alone. However, this new treatment also had more serious side effects and did not improve overall survival. This doesn't mean that chemotherapy is not a good treatment option for this type of brain cancer. More research is needed to determine if other drugs may work better and cause fewer side effects, or whether chemotherapy would be more effective if it is given at the same time as radiation therapy.
The second part of the study found a correlation between the genetic profile of a brain tumor and patient survival, which may someday help doctors plan individualized treatment.