Oligoastrocytoma medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
The predominant therapy for oligoastrocytoma is surgical resection. Adjunctive chemotherapy and radiation are required.<ref name=rxcanada>Treatment of mixed gliomas. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/brain-and-spinal-tumours/mixed-glioma/?region=on. Accessed on October 20, 2015</ref><ref name=rxchemo>Chemotherapeutic drugs in malignant gliomas. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/treatment/chemotherapy/?region=on. Accessed on October 20, 2015</ref> Supportive therapy for oligodendroglioma includes [[anticonvulsants]] and [[corticosteroids]].<ref name=rxcanada>Treatment of mixed gliomas. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/brain-and-spinal-tumours/mixed-glioma/?region=on. Accessed on October 20, 2015</ref> | The predominant therapy for oligoastrocytoma is surgical resection. Adjunctive chemotherapy and radiation are required.<ref name=rxcanada>Treatment of mixed gliomas. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/brain-and-spinal-tumours/mixed-glioma/?region=on. Accessed on October 20, 2015</ref><ref name=rxchemo>Chemotherapeutic drugs in malignant gliomas. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/treatment/chemotherapy/?region=on. Accessed on October 20, 2015</ref><ref name="pmid12107116">{{cite journal| author=Mueller W, Hartmann C, Hoffmann A, Lanksch W, Kiwit J, Tonn J et al.| title=Genetic signature of oligoastrocytomas correlates with tumor location and denotes distinct molecular subsets. | journal=Am J Pathol | year= 2002 | volume= 161 | issue= 1 | pages= 313-9 | pmid=12107116 | doi=10.1016/S0002-9440(10)64183-1 | pmc=PMC1850690 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12107116 }} </ref> Supportive therapy for oligodendroglioma includes [[anticonvulsants]] and [[corticosteroids]].<ref name=rxcanada>Treatment of mixed gliomas. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/brain-and-spinal-tumours/mixed-glioma/?region=on. Accessed on October 20, 2015</ref> | ||
==Medical Therapy== | ==Medical Therapy== | ||
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*Symptomatic, aggressive, enlarging, enhancing, and non-anaplastic oligodendrogliomas respond better to [[chemotherapy]].<ref name="pmid1641113">{{cite journal| author=Cairncross JG, Macdonald DR, Ramsay DA| title=Aggressive oligodendroglioma: a chemosensitive tumor. | journal=Neurosurgery | year= 1992 | volume= 31 | issue= 1 | pages= 78-82 | pmid=1641113 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1641113 }} </ref> | *Symptomatic, aggressive, enlarging, enhancing, and non-anaplastic oligodendrogliomas respond better to [[chemotherapy]].<ref name="pmid1641113">{{cite journal| author=Cairncross JG, Macdonald DR, Ramsay DA| title=Aggressive oligodendroglioma: a chemosensitive tumor. | journal=Neurosurgery | year= 1992 | volume= 31 | issue= 1 | pages= 78-82 | pmid=1641113 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1641113 }} </ref> | ||
*[[Temozolomide]] ([[Temodar]]) is the preferred drug for the treatment of oligoastrocytoma.<ref name=rxcanada>Treatment of mixed gliomas. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/brain-and-spinal-tumours/mixed-glioma/?region=on. Accessed on October 20, 2015</ref> | *[[Temozolomide]] ([[Temodar]]) is the preferred drug for the treatment of oligoastrocytoma.<ref name=rxcanada>Treatment of mixed gliomas. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/brain-and-spinal-tumours/mixed-glioma/?region=on. Accessed on October 20, 2015</ref> | ||
*[[PCV regimen|PCV 3 regimen]] is the preferred combination chemotherapy for oligoastrocytoma. | *[[PCV regimen|PCV 3 regimen]] is the preferred combination chemotherapy for oligoastrocytoma.<ref name="pmid12107116">{{cite journal| author=Mueller W, Hartmann C, Hoffmann A, Lanksch W, Kiwit J, Tonn J et al.| title=Genetic signature of oligoastrocytomas correlates with tumor location and denotes distinct molecular subsets. | journal=Am J Pathol | year= 2002 | volume= 161 | issue= 1 | pages= 313-9 | pmid=12107116 | doi=10.1016/S0002-9440(10)64183-1 | pmc=PMC1850690 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12107116 }} </ref> | ||
**[[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.<ref name="pmid7407756">{{cite journal| author=Levin VA, Edwards MS, Wright DC, Seager ML, Schimberg TP, Townsend JJ et al.| title=Modified procarbazine, CCNU, and vincristine (PCV 3) combination chemotherapy in the treatment of malignant brain tumors. | journal=Cancer Treat Rep | year= 1980 | volume= 64 | issue= 2-3 | pages= 237-44 | pmid=7407756 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7407756 }} </ref> | **[[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.<ref name="pmid7407756">{{cite journal| author=Levin VA, Edwards MS, Wright DC, Seager ML, Schimberg TP, Townsend JJ et al.| title=Modified procarbazine, CCNU, and vincristine (PCV 3) combination chemotherapy in the treatment of malignant brain tumors. | journal=Cancer Treat Rep | year= 1980 | volume= 64 | issue= 2-3 | pages= 237-44 | pmid=7407756 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7407756 }} </ref> | ||
*Other chemotherapeutic drugs that may be used for the treatment of oligoastrocytoma include:<ref name=rxchemo>Chemotherapeutic drugs in malignant gliomas. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/treatment/chemotherapy/?region=on. Accessed on October 20, 2015</ref> | *Other chemotherapeutic drugs that may be used for the treatment of oligoastrocytoma include:<ref name=rxchemo>Chemotherapeutic drugs in malignant gliomas. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/treatment/chemotherapy/?region=on. Accessed on October 20, 2015</ref> | ||
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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
The predominant therapy for oligoastrocytoma is surgical resection. Adjunctive chemotherapy and radiation are required.[1][2][3] Supportive therapy for oligodendroglioma includes anticonvulsants and corticosteroids.[1]
Medical Therapy
The medical therapy of oligodendroglioma includes:
Radiotherapy
- Post-operative radiotherapy is recommended among all patients who develop oligoastrocytoma.[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]
- It may also be given as the main treatment, if surgery is not an option.
- 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.[4]
Chemotherapy
- Chemotherapy is indicated as adjuvant therapy for oligoastrocytoma.[1]
- Oligodendroglioma is the most chemosensitive of all the glial tumors.[5]
- Symptomatic, aggressive, enlarging, enhancing, and non-anaplastic oligodendrogliomas respond better to chemotherapy.[6]
- Temozolomide (Temodar) is the preferred drug for the treatment of oligoastrocytoma.[1]
- PCV 3 regimen is the preferred combination chemotherapy for oligoastrocytoma.[3]
- 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.[7]
- Other chemotherapeutic drugs that may be used for the treatment of oligoastrocytoma include:[2]
- If oligoastrocytoma is unresponsive to the chemotherapeutic drugs used in earlier treatments or if it recurs, other drugs that may be used include:[2]
- The advanced mode of delivery of chemotherapeutic drugs to the brain include:[2]
- Intraventrical chemotherapy
- Interstitial chemotherapy
- Convection-enhanced delivery
Supportive treatment
Supportive therapy for oligoastrocytoma includes anticonvulsants and corticosteroids, which focuses on relieving symptoms and improving the patient’s neurologic function. The types of supportive therapy that may be used are:[1]
- Anticonvulsants
- Corticosteroids
- These drugs are used to reduce cerebral edema.
- The most commonly used corticosteroid is dexamethasone (Decadron).
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Treatment of mixed gliomas. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/brain-and-spinal-tumours/mixed-glioma/?region=on. Accessed on October 20, 2015
- ↑ 2.0 2.1 2.2 2.3 Chemotherapeutic drugs in malignant gliomas. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/treatment/chemotherapy/?region=on. Accessed on October 20, 2015
- ↑ 3.0 3.1 Mueller W, Hartmann C, Hoffmann A, Lanksch W, Kiwit J, Tonn J; et al. (2002). "Genetic signature of oligoastrocytomas correlates with tumor location and denotes distinct molecular subsets". Am J Pathol. 161 (1): 313–9. doi:10.1016/S0002-9440(10)64183-1. PMC 1850690. PMID 12107116.
- ↑ 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.
- ↑ 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.