Oligodendroglioma medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[2]Sujit Routray, M.D. [3]
Overview
The predominant therapy for oligodendroglioma is surgical resection. Adjunctive chemotherapy and radiation are required.[1][2][3][4] 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 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 of 60 Gy.[5]
Chemotherapy
- Chemotherapy is indicated as adjuvant therapy for oligodendroglioma.[1]
- Oligodendroglioma responds better to chemotherapy than astrocytoma of comparable grade.[6]
- Oligodendroglioma is the most chemosensitive of all the glial tumors.[2]
- Symptomatic, aggressive, enlarging, enhancing, and non-anaplastic oligodendrogliomas respond better to chemotherapy.[7]
- Temozolomide (Temodar) is the preferred drug for the treatment of oligodendroglioma.[1]
- PCV 3 regimen is the preferred combination chemotherapy for anaplastic oligodendroglioma.[1][4]
- 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.[8]
- Other chemotherapeutic drugs that may be used for the treatment of oligodendroglioma include:[3][2]
- If oligodendroglioma is unresponsive to the chemotherapeutic drugs used in earlier treatments or if it recurs, other drugs that may be used include:[3]
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 1.6 1.7 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
- ↑ 2.0 2.1 2.2 Cairncross JG, Macdonald DR (1988). "Successful chemotherapy for recurrent malignant oligodendroglioma". Ann Neurol. 23 (4): 360–4. doi:10.1002/ana.410230408. PMID 3382171.
- ↑ 3.0 3.1 3.2 Chemotherapeutic drugs in malignant gliomas. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/treatment/chemotherapy/?region=on
- ↑ 4.0 4.1 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.
- ↑ Stupp R, Tonn JC, Brada M, Pentheroudakis G, ESMO Guidelines Working Group (2010). "High-grade malignant glioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up". Ann Oncol. 21 Suppl 5: v190–3. doi:10.1093/annonc/mdq187. PMID 20555079.
- ↑ 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). - ↑ 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.