Oligodendroglioma medical therapy: Difference between revisions
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*Radiotherapy may not cure the cancer but can control the tumor, delay recurrence, and increase survival. | *Radiotherapy may not cure the cancer but can control the tumor, delay recurrence, and increase survival. | ||
*[[Radiation|External beam radiation therapy]] is preferred to whole brain radiotherapy.<ref name=rx>Treatment of oligodendroglioma. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/brain-and-spinal-tumours/oligodendroglioma/?region=on</ref> | *[[Radiation|External beam radiation therapy]] is preferred to whole brain radiotherapy.<ref name=rx>Treatment of oligodendroglioma. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/brain-and-spinal-tumours/oligodendroglioma/?region=on</ref> | ||
*External beam radiation therapy is usually administered in standard fractions of 1.8–2 Gy and can reach a total dose in the range of 54–60 Gy.<ref name="pmid26251628">{{cite journal| author=Simonetti G, Gaviani P, Botturi A, Innocenti A, Lamperti E, Silvani A| title=Clinical management of grade III oligodendroglioma. | journal=Cancer Manag Res | year= 2015 | volume= 7 | issue= | pages= 213-23 | pmid=26251628 | doi=10.2147/CMAR.S56975 | pmc=PMC4524382 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26251628 }} </ref> | |||
===Chemotherapy=== | ===Chemotherapy=== | ||
Revision as of 18:26, 13 October 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Overview
Medical Therapy
The medical therapy of oligodendroglioma includes:
Radiotherapy
- Post-operative radiotherapy is recommended among all patients who develop oligodendroglioma.[1]
- Radiotherapy may not cure the cancer but can control the tumor, delay recurrence, and increase survival.
- External beam radiation therapy is preferred to whole brain radiotherapy.[1]
- External beam radiation therapy is usually administered in standard fractions of 1.8–2 Gy and can reach a total dose in the range of 54–60 Gy.[2]
Chemotherapy
- Chemotherapy is indicated as adjuvant therapy for oligodendroglioma.[1]
- Oligodendroglioma responds better to chemotherapy than astrocytoma of comparable grade.[3]
- Oligodendroglioma is the most chemosensitive of all the glial tumors.[4]
- Symptomatic, aggressive, enlarging, enhancing, and non-anaplastic oligodendrogliomas respond better to chemotherapy.[5]
- Temozolomide (Temodar) is the preferred drug for the treatment of oligodendroglioma.[1]
- PCV 3 regimen is the preferred combination chemotherapy for anaplastic oligodendroglioma.[1]
- CCNU is administered on day 1, procarbazine is administered daily for 14 days beginning on day 8, and vincristine is administered on days 8 and 29 of each 6-week cycle of therapy.[6]
- Other chemotherapeutic drugs that may be used for the treatment of oligodendroglioma include:[7][4]
- If oligodendroglioma is unresponsive to the chemotherapeutic drugs used in earlier treatments or if it recurs, other drugs that may be used include:[7]
Supportive treatment
- Supportive therapy for oligodendroglioma includes anticonvulsants and corticosteroids, which focuses on relieving symptoms and improving the patient’s neurologic function.[1]
- Anticonvulsants are administered to the patients who have a seizure. Phenytoin given concurrently with radiation may have serious skin reactions such as erythema multiforme and Stevens-Johnson syndrome.
- Corticosteroids, usually dexamethasone given 4-10 mg every 4-6 h, can reduce peritumoral edema, diminish mass effect, and lower intracranial pressure with a decrease in symptoms (headache or drowsiness).
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Treatment of oligodendroglioma. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/brain-and-spinal-tumours/oligodendroglioma/?region=on
- ↑ Simonetti G, Gaviani P, Botturi A, Innocenti A, Lamperti E, Silvani A (2015). "Clinical management of grade III oligodendroglioma". Cancer Manag Res. 7: 213–23. doi:10.2147/CMAR.S56975. PMC 4524382. PMID 26251628.
- ↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID doi:10.1016/S0090-3019(03)00167-8 Check
|pmid=value (help). - ↑ 4.0 4.1 Cairncross JG, Macdonald DR (1988). "Successful chemotherapy for recurrent malignant oligodendroglioma". Ann Neurol. 23 (4): 360–4. doi:10.1002/ana.410230408. PMID 3382171.
- ↑ Cairncross JG, Macdonald DR, Ramsay DA (1992). "Aggressive oligodendroglioma: a chemosensitive tumor". Neurosurgery. 31 (1): 78–82. PMID 1641113.
- ↑ Levin VA, Edwards MS, Wright DC, Seager ML, Schimberg TP, Townsend JJ; et al. (1980). "Modified procarbazine, CCNU, and vincristine (PCV 3) combination chemotherapy in the treatment of malignant brain tumors". Cancer Treat Rep. 64 (2–3): 237–44. PMID 7407756.
- ↑ 7.0 7.1 Chemotherapeutic drugs in malignant gliomas. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/treatment/chemotherapy/?region=on