Materiały źródłowe

• #1 Oligodendroglioma: Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/21191-oligodendroglioma

  Oligodendrogliomas are among the more treatable brain tumors and cancers. The treatment often involves multiple methods, including: Surgery, Chemotherapy, Radiation therapy. […] Brain surgery aims to remove as much of the tumor as possible. Sometimes, a neurosurgeon can remove the whole tumor. The success rate of surgery depends strongly on the type of oligodendroglioma, how much its progressed, the tumors location, your surgeons expertise and other factors. […] Certain chemotherapy drugs are very effective against oligodendroglioma. The most likely chemotherapy treatments are: The PCV regimen: The name of this regimen comes from the three drugs it consists of: procarbazine, lomustine (often known by its chemical abbreviation CCNU, making it the C in PCV) and vincristine. PCV is generally the first option for treating oligodendroglioma.

• #1 Survey of treatment recommendations for anaplastic oligodendroglioma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1907408/

  Anaplastic oligodendroglioma is a malignant brain tumor uniquely sensitive to treatment with both chemotherapy and radiotherapy. […] The current recommended management of anaplastic oligodendrogliomas by the National Comprehensive Cancer Network (NCCN) is maximal resection followed by focal radiotherapy (RT) with or without adjuvant chemotherapy. […] The survey asked respondents to indicate their preferred treatment for a patient with a newly diagnosed anaplastic oligodendroglioma, given a variety of genetic scenarios. Overall, the most frequent recommendation made by approximately one-third of respondents was the concurrent administration of temozolomide and RT followed by adjuvant temozolomide when 1p/19q information was unavailable, both chromosomes were intact, or 1p was intact. […] For patients with 1p and 19q loss, respondents were more likely to recommend chemotherapy alone (42%) (with either temozolomide [34%] or PCV [8%]).

• #2 Oligodendroglioma | The Brain Tumour Charity

  https://www.thebraintumourcharity.org/brain-tumour-diagnosis-treatment/types-of-brain-tumour-adult/oligodendroglioma/

  Oligodendrogliomas account for roughly 3% of all primary brain tumours. Because of this, there are various treatment methods, which we discuss here. […] Treatment can range from watch and wait to neurosurgery, radiotherapy, and chemotherapy. […] As grade 2 oligodendrogliomas grow slowly, you may be put on active monitoring (also known as watch and wait) if no treatment is required immediately. […] If the tumour is large or causing symptoms that affect your quality of life, neurosurgery may be performed to remove as much as possible. This may be followed with radiotherapy or chemotherapy. […] Grade 3 oligodendrogliomas are usually treated with surgery soon after diagnosis. This is usually followed by a combination of radiotherapy and chemotherapy because oligodendrogliomas are often diffuse, which means they’re more difficult to remove completely.

• #2 Oligodendroglioma: Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/21191-oligodendroglioma

  Radiation therapy is very common with oligodendroglioma. This approach bombards tumor cells with enough energy to destroy them. The radiation is targeted as precisely as possible. The goal is to destroy as much of a tumor as possible while leaving surrounding healthy tissue unharmed. […] Oligodendrogliomas are treatable, but not technically curable, tumors. The most likely approach to treating oligodendroglioma is to remove the whole tumor (or as much of it as possible) and then your care team determines if chemotherapy, radiation therapy or a combination of these are necessary to eradicate any remaining cancer cells. […] Oligodendroglioma generally responds well to multiple forms of treatment, and most people with it will survive for many years. Better still, advances in treatment options offer the chance for higher survival odds and quality of life for people with oligodendroglioma.

• #3 Oligodendroglioma: Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/21191-oligodendroglioma

  Radiation therapy is very common with oligodendroglioma. This approach bombards tumor cells with enough energy to destroy them. The radiation is targeted as precisely as possible. The goal is to destroy as much of a tumor as possible while leaving surrounding healthy tissue unharmed. […] Oligodendrogliomas are treatable, but not technically curable, tumors. The most likely approach to treating oligodendroglioma is to remove the whole tumor (or as much of it as possible) and then your care team determines if chemotherapy, radiation therapy or a combination of these are necessary to eradicate any remaining cancer cells. […] Oligodendroglioma generally responds well to multiple forms of treatment, and most people with it will survive for many years. Better still, advances in treatment options offer the chance for higher survival odds and quality of life for people with oligodendroglioma.

• #4 Oligodendroglioma | UCSF Brain Tumor Center

  https://braintumorcenter.ucsf.edu/condition/oligodendroglioma

  There is no cure for oligodendroglioma. Depending on the size and location of the tumor, patients with oligodendroglioma are usually first treated with surgery. The primary objective is to remove as much of the tumor as possible, while protecting critical brain function this is called maximal safe gross total resection. […] Chemotherapy and radiation may also be suggested in addition to surgery, especially for patients with anaplastic oligodendroglioma and in cases where the entire tumor is unable to be completely resected.

• #5 Oligodendrogliomas Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York City

  https://www.neurosurgery.columbia.edu/patient-care/conditions/oligodendrogliomas

  Oligodendrogliomas are tumors that develop from a certain type of cell called oligodendroglial progenitor cells. […] At Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, we specialize in diagnosing and surgically treating oligodendrogliomas. Standard treatment options include careful monitoring, chemotherapy, radiotherapy, and surgical removal. […] Treatment may vary depending on several factors, such as tumor grade and location. Our neurosurgeons know that each patients tumor is different and requires a customized approach. […] For high-grade tumors, the standard treatment is brain tumor surgery, in which as much of the tumor as possible is surgically removed. A neurosurgeon performs a craniotomy to access and remove the tumor. Radiation therapy, chemotherapy, or a combination of both may be recommended to eliminate any tumor that remains after surgery.

• #6 Oligodendroglioma – Symptoms, Diagnosis, TreatmentSecond Opinion IconGroup 9Second Opinion IconGroup 49

  https://www.barrowneuro.org/condition/oligodendroglioma/

  Neurosurgical resection is often the first step in treating gliomas, particularly if your neurosurgeon can safely reach the tumor. The goal of surgery is to remove as much of the tumor as possible—known as a maximal resection—while minimizing damage to surrounding healthy brain tissue. […] Surgery to remove as much of the tumor as is safely possible is generally the first step in treatment. This, in turn, will reduce your symptoms while supporting long-term control of the tumor, especially when combined with other treatments or therapies. […] Even with maximal resection, oligodendroglioma cells may remain, so neuro-oncologists often recommend follow-up treatments like radiation or chemotherapy. Regular imaging is also vital to check for recurrence. […] Following surgery, oligodendrogliomas often require nonsurgical treatments to target the remaining tumor cells and reduce the risk of recurrence. And for those with favorable genetic markers, nonsurgical treatments can effectively manage oligodendrogliomas.

• #7 Oligodendrogliomas Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York City

  https://www.neurosurgery.columbia.edu/patient-care/conditions/oligodendrogliomas

  If the tumor is located in an area in the brain where a neurosurgeon cannot safely access and remove it, a stereotactic biopsy is performed to confirm the tumor grade. On the basis of the biopsy results, a neurosurgeon chooses the best course of radiation therapy and/or chemotherapy for a patients tumor.

• #8 Oligodendroglioma Symptoms and Treatment | UPMC | Pittsburgh, PA

  https://www.upmc.com/services/neurosurgery/brain/conditions/brain-tumors/oligodendroglioma

  At UPMC, the preferred surgical treatment for a oligodendroglioma is Neuroendoport surgery. Neuroendoport surgery gives surgeons access to the tumor through a dime-size channel. This minimally invasive approach offers benefits such as: […] Whenever possible, the tumor is removed surgically. Various methods may be used to treat oligodendrogliomas. These treatments may be used together or individually. […] Neuroendoport surgery offers a minimally invasive treatment option for deep-seated tumors within the substance of the brain or within the ventricles (fluid spaces). A narrow tube or port allows doctors to access tumors through a tiny incision in the scalp, in contrast to traditional brain surgery. […] Radiation is commonly used to treat brain tumors, either alone or in combination with surgery and/or chemotherapy. […] Chemotherapy uses drugs to stop the growth of cancer cells.

• #9 Oligodendroglioma – Neurosurgery | UCLA Health

  https://www.uclahealth.org/medical-services/neurosurgery/conditions-treated/oligodendroglioma

  UCLA offers a multidisciplinary management of oligodendroglioma, with experts in neurosurgery, radiation oncology and neuro-oncology working closely together to assure the highest quality of care. […] Your UCLA neurosurgeon will determine with you how much of the tumor can or should be removed. If the tumor is surgically accessible, a „complete” removal is attempted. […] Sometimes, oligodendroglioma are best removed with the aid of intra-operative MRI, allowing the most complete, safest surgery possible. […] Radiation therapy may be considered after surgical removal. […] The UCLA Neuro-Oncology Program offers the latest in promising medical therapies. […] For anaplastic oligodendroglioma (a more aggressive type of oligodendroglioma), chemotherapy can be very effective if the tumor demonstrates certain chromosomal (gene) defects.

• #10 Oligodendroglioma – Symptoms, Diagnosis, TreatmentSecond Opinion IconGroup 9Second Opinion IconGroup 49

  https://www.barrowneuro.org/condition/oligodendroglioma/

  Radiation therapy uses precisely aimed beams of radiation to destroy tumors in the body. While it doesn’t remove the tumor, radiation therapy damages the DNA of the tumor cells, which then lose their ability to reproduce and eventually die. Radiation therapy is often used after surgery—particularly for Grade 3 oligodendrogliomas—to reduce the risk of recurrence. […] Chemotherapy relies on drugs given orally or intravenously to kill or stop the growth of cancer cells. It’s often used after surgery, in Grade 3 oligodendrogliomas, or reoccurring Grade 2 oligodendrogliomas. […] Targeted therapies attempt to inhibit specific molecular pathways or mutations in tumor cells, aiming to halt tumor growth. […] Pain management: To help improve daily function, medications for pain, anti-nausea, and other supportive therapies may be prescribed.

• #11 Oligodendroglioma | Brain (and spinal cord) tumours | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/brain-tumours/types/oligodendroglioma

  Treatment depends on whether the oligodendroglioma is low grade (slow growing) or high grade (fast growing). […] The main treatments for oligodendroglioma are: surgery to remove as much tumour as possible, radiotherapy, which uses high energy x-rays to destroy cancer cells, chemotherapy, which uses cytotoxic drugs to destroy cancer cells. […] Surgery is usually the first treatment you have. The exact type of surgery you have depends on where the tumour is and how big it is. A highly specialist doctor (neurosurgeon) removes as much of the tumour as possible. […] You might have radiotherapy straight after surgery if doctors can see tumour left behind after surgery or you are over 40 years old. […] You might have chemotherapy before or after radiotherapy. Chemotherapy uses cytotoxic drugs to destroy cancer cells. You usually have a combination of chemotherapy drugs called PCV.

• #12 Oligodendroglioma – American Brain Tumor Association | Learn More

  https://www.abta.org/tumor_types/oligodendroglioma/

  A recurring oligodendroglioma may be treated with surgery, particularly when the time between initial diagnosis and recurrence is extended. […] In this way, the diagnosis can be updated to reflect any molecular changes that may have occurred over time, whether they be naturally occurring or associated with any treatments including radiation, chemotherapy, or immunotherapy. […] They may also be treated with radiation therapy, depending on whether or how much radiation was given after the original diagnosis. […] Chemotherapy/immunotherapy, targeted therapy, and clinical trials are additional options.

• #13 Oligodendroglioma – American Brain Tumor Association | Learn More

  https://www.abta.org/tumor_types/oligodendroglioma/

  If the tumor is located in a region of the brain that is accessible, then the usual treatment for oligodendroglioma is surgical removal of as much of the tumor tissue as possible. […] In instances in which the tumor is able to be removed, surgery may be the only treatment needed. Biopsy is typically performed on tumors that are not accessible to confirm the diagnosis and help guide treatment. […] If some of the tumor remains (also called residual tumor) or if the tumor has molecular characteristics that suggest it may be more likely to recur, radiation treatment may be recommended following surgery. Radiation therapy generally takes place over the course of a six-week time period and may be given along with chemotherapy. […] Depending upon the amount of tumor that is not able to be removed (residual tumor) and the molecular characteristics of the tumor itself, chemotherapy or targeted therapy may be suggested to treat the remaining tumor. Chemotherapy may be administered via a pill or an intravenous injection. Vorasidinib, a targeted therapy, was recently approved by the FDA to treat grade 2 oligodendrogliomas with IDH mutations. This medication, taken once daily, has been shown to slow tumor regrowth.

• #14 Oligodendroglioma | MedLink Neurology

  https://www.medlink.com/articles/oligodendroglioma

  In addition to obtaining tissue for definitive diagnosis, surgery can also alleviate symptoms from mass effect. […] It is standard of care to achieve maximal resection provided that it can be done safely, though this approach is controversial in young patients with small, asymptomatic lesions. […] Because surgery alone is not curative, additional treatment modalities such as radiation and chemotherapy ought to be considered in the plan of care. […] The optimal timing of such treatments is undefined, particularly in low-grade gliomas, as the benefits of early radiation must be weighed against the potential for cognitive impairment in the future. […] For low-grade gliomas, the delivery of 4500 cGy to 5400 cGy in 180 cGy daily fractions is recommended. […] For high-grade gliomas, a total prescribed dose of 5940 cGy in 180 cGy daily fractions is recommended, although a total prescribed dose of 5400 cGy to 5760 cGy in 180 cGy daily fractions may also be considered.

• #15 Can Oligodendroglioma Be Cured?

  https://www.emedicinehealth.com/can_oligodendroglioma_be_cured/article_em.htm

  Oligodendroglioma, a rare tumor that starts in the brain or spinal cord, has no cure. Catching the cancer early and starting treatment is the best way to prolong life — people with stage II of this kind of cancer live an average of 12 years after diagnosis. […] Treatment for oligodendrogliomas usually involves surgical removal of the tumor followed by chemotherapy and/or radiation therapy. […] Surgery is the first treatment, when possible, with the goal to remove as much tumor as possible without causing more symptoms. […] Chemotherapy options include Procarbazine, Lomustine, Vincristine, and Temozolomide (being studied in clinical trials). […] External beam radiation therapy (EBRT) options include three-dimensional conformal radiation therapy (3D-CRT), intensity modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT), stereotactic radiosurgery (SRS)/stereotactic radiotherapy (SRT), image-guided radiation therapy (IGRT), and whole brain and spinal cord radiation therapy (craniospinal radiation).

• #16 Oligodendroghoma | North Bristol NHS Trust

  https://www.nbt.nhs.uk/bnog/bnog-treatments/oligodendroghoma

  The role of chemotherapy for the treatment of oligodendroglioma was well established by several studies using nitrosourea-based therapy. Most used procarbazine, lomustine (CCNU), and vincristine, a combination chemotherapy regimen (ie, PCV). Several studies have evaluated the role of temozolomide as second-line chemotherapy for recurrent oligodendroglioma and showed a response rate of about 25% for patients relapsing after PCV therapy. Recently it has been shown that initial treatment post surgery for grade 3 gliomas including oligodendrogliomas with either radiotherapy or chemotherapy (either with PCV or Temozolomide) did not make any difference to the overall progression free survival. […] Various studies compared the effects of radiation therapy before and after the maximal surgical resection. The studies showed that the immediate postoperative irradiation in patients with low grade gliomas (grade 2) increases the median progression-free survival by 2 years without affecting the overall survival. This result suggests that radiation therapy can be withheld until a clinical or radiologic progression occurs to delay the sequelae of cranial irradiation.

• #17 Oligodendroglial brain tumor survivors run the risk of developing long-term cognitive impairment – IDIBELL

  https://idibell.cat/en/2019/10/oligodendroglial-brain-tumor-survivors-run-the-risk-of-developing-long-term-cognitive-impairment/

  Oligodendroglioma is one of the few brain tumors in which current treatments achieve prolonged and significant survival rates. […] The current treatment consists of surgery and radiotherapy on the brain, along with chemotherapy schemes. […] At present, standard treatment of oligodendroglial tumor patients includes chemotherapy (procarbazine, lomustine and vincristine) and cranial radiation therapy, a combination that significantly improves overall survival and progression-free survival of grade II and III oligodendrogliomas. […] Therefore, the impact of the long-term effects of cancer treatment in patients with oligodendroglial tumor has become an increasingly relevant aspect, especially regarding cognitive functioning. […] Results obtained indicate that long-term survivors of an oligodendroglial tumor that underwent a standard treatment of radiotherapy and chemotherapy, show cognitive impairment after more than five years of its completion, especially in memory and executive functions. […] These results obtained by the IDIBELL group show, for the first time, the need to develop new treatment strategies for patients with oligodendroglial tumors for which long survival is expected.

• #18 First-line chemotherapeutic treatment for oligodendroglioma, WHO grade 3—PCV or temozolomide?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9113249/

  Two landmark phase III randomized controlled trials studied the effect of adding PCV to radiotherapy in patients with a grade 3 oligodendroglioma. Both the EORTC-26951 (n = 368) and the RTOG-9402 (n = 291) showed that adding PCV chemotherapy to radiotherapy gave a statistically significant longer progression-free survival (PFS), but a similar overall survival (OS) compared to radiotherapy alone. […] Considering the above mentioned retrospective and prospective studies, PCV chemotherapy, compared to temozolomide, appears to furnish and improve PFS, but the OS is similar. However, despite greater published evidence for the use of PCV, temozolomide seems to be used more often in clinical practice, with reports over the last decade indicating that 71%-88% of patients with anaplastic oligodendrogliomas received temozolomide as front-line chemotherapy.

• #19 Oligodendroglioma medical therapy – wikidoc

  https://wikidoc.org/index.php/Oligodendroglioma_medical_therapy

  The predominant therapy for oligodendroglioma is surgical resection. Adjunctive chemotherapy and radiation are required. Supportive therapy for oligodendroglioma includes anticonvulsants and corticosteroids. […] The medical therapy for oligodendroglioma includes: […] Post-operative radiotherapy is recommended among all patients who develop oligodendroglioma. […] Radiotherapy may not cure the cancer but it can: Control the tumor, Delay recurrence, Increase survival. […] Chemotherapy is indicated as adjuvant therapy for oligodendroglioma. […] Oligodendroglioma responds better to chemotherapy than astrocytoma of comparable grade. […] Oligodendroglioma is the most chemosensitive of all the glial tumors. […] Symptomatic, aggressive, enlarging, enhancing, and non-anaplastic oligodendrogliomas respond better to chemotherapy.

• #20 Oligodendroglioma | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/brain-and-spinal-cord/what-is-a-brain-or-spinal-cord-tumour/oligodendroglioma

  Oligodendrogliomas are a type of glioma that starts in glial cells called oligodendrocytes. Oligodendrogliomas are classified as low grade (grade 2) or high grade (grade 3). […] The following are treatments for low-grade oligodendrogliomas: Surgery may be done to remove all of the tumour or as much of the tumour as possible. Active surveillance with regular MRI scans may be done to watch for growth of the tumour if it cant be completely removed with surgery. Radiation therapy may be given after surgery if the tumour cant be completely removed or if it regrows after surgery and radiation therapy was not given previously. Chemotherapy may be given after surgery, usually with radiation therapy, if the tumour cant be completely removed. It may also be used to treat tumours that have come back after treatment (called recurrent low-grade oligodendrogliomas). The most common chemotherapy drug used is temozolomide (Temodal). The most common chemotherapy drug combination used is PCV, which is procarbazine (Matulane), lomustine (CeeNU, CCNU) and vincristine (Oncovin).

• #21 Oligodendroglioma | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/brain-and-spinal-cord/what-is-a-brain-or-spinal-cord-tumour/oligodendroglioma

  The following are treatments for anaplastic oligodendrogliomas. Surgery may be done to remove all of the tumour or as much of the tumour as possible followed by radiation therapy, with or without chemotherapy. Radiation therapy is usually given after surgery. It may also be given as the main treatment if surgery cant be done. Chemotherapy is given after surgery, usually with radiation therapy. It may also be used to treat tumours that have come back after treatment (called recurrent anaplastic oligodendrogliomas). The most common chemotherapy drug used is temozolomide. The most common chemotherapy drug combination used is PCV (procarbazine, lomustine and vincristine).

• #22 Oligodendroglioma | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/glioma/types/oligodendroglioma

  Surgery is the first and most valuable treatment option, particularly when a tumor is pushing on the parts of the brain and causing symptoms. In patients without symptoms, surgery also improves overall survival. Care is taken to avoid damage to nearby structures during surgery, and minimize the risk of complications. […] Most oligodendrogliomas respond well to chemotherapy. Examples of a common oral chemotherapy regimen includes a combination of: Matulane (procarbazine) slows down synthesis of DNA, RNA, and protein in tumor cells. Gleostine (lomustine) blocks DNA replication in tumor cells and prevents new cell division. Oncovin (vincristine) prevents tumor cell replication and causes tumor cell death. Temodar (temozolomide) can be given orally or intravenously. It works by binding to DNA causing tumor cell destruction. Temozolomide may be particularly useful in high-grade and recurrent oligodendrogliomas.

• #23

  https://link.springer.com/article/10.1007/s11940-013-0218-9

  The optimal treatment strategy for anaplastic oligodendroglial (AO) tumors is evolving. […] Long term follow up data of the Radiation Therapy Oncology Group (RTOG) 9402 and the European Organisation for Research and Treatment of Cancer (EORTC) 26951 studies demonstrate clear evidence that for patients with codeleted 1p19q AO, early chemotherapy with radiation offers a significant improvement in overall survival compared with early radiation, even with salvage chemotherapy at tumor relapse, and thus establishes the 1p19q allelic loss as a predictive marker distinct from tumors without the chromosome change. Radiotherapy alone is no longer considered an adequate treatment for this patient population. […] With the availability of this long term follow up data, there is now further clarity regarding treatment for 1p19q codeleted AOs as early chemotherapy with radiation offers a significant improvement in OS compared with early radiation alone even with salvage chemotherapy at tumor relapse. Consequently, radiotherapy alone is no longer considered an adequate treatment for this patient population.

• #24 Oligodendroglioma medical therapy – wikidoc

  https://wikidoc.org/index.php/Oligodendroglioma_medical_therapy

  Temozolomide (Temodar) is the preferred drug for the treatment of oligodendroglioma. […] PCV 3 regimen is the preferred combination chemotherapy for anaplastic oligodendroglioma. […] Supportive therapy for oligodendroglioma focuses on relieving symptoms and improving the patients neurologic function.

• #25 Reddit – The heart of the internet

  https://www.reddit.com/r/braincancer/comments/uwjwyj/chemo_options_for_treating_recurrence_of_grade_2/

  Chemo options for treating recurrence of grade 2 oligodendroglioma: PCV vs TMZ […] Consequently, the standard of care treatment is being recommended: 6 weeks fractionated radiation (IMRT) with concurrent chemotherapy and 6-12 cycles of adjuvant chemotherapy. For the chemotherapy, they have suggested two options: 1) Temozolomide (TMZ) aka Temodar, which is taken orally or 2) PCV (procarbazine, lomustine aka CCNU, and vincristine), which has oral and intravenous components. […] My understanding is that PCV has long been the standard of care (~30 yrs?) and has clinical studies behind it, however, has a high drop-out rate due to its toxicity. TMZ was introduced as an alternative when PCV was unavailable due to production issues (~20 yrs ago?) and became popular because it was simpler logistically (oral-only) and better tolerated than PCV having far less toxicity. […] Anecdotally, it seems many clinical trials for treating low grade gliomas (LGGs) are using TMZ and not PCV, though the significance of this is unknown.

• #26 Survey of treatment recommendations for anaplastic oligodendroglioma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1907408/

  The most frequently recommended therapy was concurrent administration of temozolomide and RT followed by adjuvant temozolomide. […] Despite the recommended NCCN guidelines and results of recent EORTC and RTOG trials strongly supporting the use of RT alone or as part of the initial management of anaplastic oligodendroglioma, our respondents recommended chemotherapy alone in 3%32% of the scenarios presented. […] Temozolomide was recommended over PCV by a ratio of nearly 5:1.

• #27 First-line chemotherapeutic treatment for oligodendroglioma, WHO grade 3—PCV or temozolomide?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9113249/

  Oligodendrogliomas, WHO grade 3, are rare primary brain tumors that account for only 1.7% of diffuse glioma in adults. Patients with oligodendrogliomas have a better prognosis than those with astrocytomas, in part because these tumors exhibit unique and predictable chemosensitivity. Following surgery, initial management of oligodendroglial tumors incorporates chemotherapy with radiotherapy, but controversy surrounds which of two standard chemotherapeutic regimens, procarbazine, CCNU (ie, lomustine), and vincristine (PCV) chemotherapy or temozolomide, is superior. […] The definitive answer to this question will be determined by the outcome of the CODEL trial (NCT00887146). This phase III trial randomizes patients with oligodendrogliomas, WHO grade 3, to radiotherapy with concurrent and adjuvant temozolomide or radiotherapy with adjuvant PCV chemotherapy.

• #28 First-line chemotherapeutic treatment for oligodendroglioma, WHO grade 3—PCV or temozolomide?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9113249/

  The most recent guidelines from the European Association of Neuro-Oncology (EANO) and the American Society of Oncology (ASCO)/Society of Neuro-Oncology (SNO) recommend maximal safe surgical resection followed by radiotherapy and PCV chemotherapy for patients with an oligodendroglioma, 1p/19q co-deleted, WHO grade 3. Temozolomide is considered a reasonable alternative if there are potential concerns of PCV-related toxicity or intolerability.

• #29 Oligodendroglioma — Low Grade Glioma Registry

  https://gliomaregistry.org/oligodendroglioma

  If the tumor is located in a region of the brain that is accessible, then the usual treatment for oligodendroglioma is surgical removal of as much of the tumor tissue as possible. In instances in which the tumor is able to be removed, surgery may be the only treatment needed. Biopsy is typically performed on tumors that are not accessible to confirm the diagnosis and help guide treatment. Recurrent oligodendrogliomas are also generally treated with surgery, particularly when the time between initial diagnosis and recurrence is extended. In this way, the diagnosis can be updated to reflect any molecular changes that may have occurred over time, whether they be naturally occurring or associated with any treatments including radiation, chemotherapy, or immunotherapy. […] If some of the tumor remains (also called residual tumor) or if the tumor has molecular characteristics that suggest it may be more likely to recur, radiation treatment may be recommended following surgery. Radiation therapy generally takes place over the course of a six week time period and may be given along with chemotherapy.

• #30 Oligodendroglioma | MedLink Neurology

  https://www.medlink.com/articles/oligodendroglioma

  Long-term results of the Radiation Therapy Oncology Group (RTOG) 9802 phase III randomized trial indicate a survival benefit in patients who receive a combination of radiation and chemotherapy with PCV in patients with high-risk (older than 40 years of age or presence of residual tumor after resection) supratentorial historical diagnoses of astrocytoma, oligoastrocytoma, or oligodendroglioma WHO grade 2 compared to radiation alone. […] The survival advantage with postoperative radiation and PCV chemotherapy is also observed in anaplastic oligodendroglioma WHO grade 3. […] Thus, postoperative treatment with radiation and chemotherapy with either PCV or temozolomide has become the standard of care for anaplastic gliomas. […] Salvage treatment with surgery, radiation, chemotherapy, or some combination thereof is often considered at the time of tumor relapse or malignant transformation.

• #31 Updated: Exciting News for Patients with Grade 2 Oligodendroglioma and Astrocytoma

  https://braintumor.org/news/exciting-results-in-trial-for-grade-2-oligodendroglioma-and-astrocytoma-patients/

  The U.S. Food and Drug Administration (FDA) has approved vorasidenib (brand name: Voranigo) for the treatment of adult and pediatric patients 12 years of age and older with grade 2 astrocytoma or oligodendroglioma with an IDH1 or IDH2 mutation, following surgery including biopsy, sub-total resection, or gross total resection. […] This is the first FDA approval of a systemic therapy for patients with Grade 2 astrocytoma or oligodendroglioma with a IDH1 or IDH2 mutation. […] The trial evaluated whether a drug called vorasidenib could increase progression-free survival (also called PFS, and meaning the length of time a patient lives before their tumor worsens or resumes growing) and delay the length of time before patients needed radiation and chemotherapy (called time to next intervention, or TTNI.)

• #32 Let’s Talk About Oligodendroglioma

  https://braintumor.org/news/lets-talk-about-oligodendroglioma/

  In 2024, the U.S. Food and Drug Administration (FDA) approved vorasidenib for adults and pediatric patients (12+) with grade 2 astrocytoma or oligodendroglioma harboring an IDH1 or IDH2 mutation. This milestone marked the first-ever FDA-approved systemic therapy for these low-grade gliomas, offering patients a new option beyond traditional chemotherapy and radiation. […] Vorasidenib represents an additional option for doctors to manage these tumors. […] This is a patient population that, thankfully for our community, [usually] lives well and lives a long time, so we have to be careful when we want to give patients treatments like chemotherapy and radiation. They’re likely going to have side effects later on in life related to those treatments and they’re not inconsequential.

• #33 Updated: Exciting News for Patients with Grade 2 Oligodendroglioma and Astrocytoma

  https://braintumor.org/news/exciting-results-in-trial-for-grade-2-oligodendroglioma-and-astrocytoma-patients/

  Results showed that patients who received vorasidenib had clear benefits in both of these measures as compared to patients who were in a control group. […] Median PFS for patients receiving vorasidenib more than doubled, going from approximately 11 months for patients in the control groups, to 28 months for patients taking the treatment, thus delaying the need for chemo and radiation for 17 months on average. […] The treatment was generally well tolerated by patients, with most significant side-effects being medically manageable. […] Vorasidenib is being developed by the biopharmaceutical company Servier. […] First, patients with these tumors have few treatment options. […] Currently, for most grade 2 IDH-mutant diffuse glioma patients, the standard of care is a watch and wait approach, followed by chemotherapy and/or radiation when the tumor begins to grow more rapidly.

• #34 Oligodendroglioma | Brain Tumor Center | Stanford Medicine

  https://med.stanford.edu/brain-tumor/conditions/glioma/oligodendroglioma.html

  Some treatment advances include: […] Tumor treating electrical fields (Optune): A device worn on the scalp delivers alternating electrical fields to prevent the growth and division of cancer cells. […] Convention-enhanced delivery Chemotherapy is slowly and continuously delivered to the tumor via a pump. […] Nanoparticle therapy Special particles allow chemotherapy drugs to cross the blood-brain barrier and improve access to the tumor. […] Ongoing research is needed to improve our understanding of brain tumors and develop more effective therapies. Some treatments currently being studied are: […] Immunotherapies. Immunotherapy is a type of treatment that uses the patient’s immune system to fight cancer. Some experimental immunotherapies for brain tumors include checkpoint inhibitors, CAR T-cell therapy, and vaccines. […] Molecular targeted therapies. Targeted therapy is a type of treatment that targets specific molecules or pathways involved in cancer growth and survival. Some experimental targeted therapies for brain tumors include drugs that target mutations in the IDH1 and IDH2 genes.

• #35 Frontiers | Oligodendroglioma: A Review of Management and Pathways

  https://www.frontiersin.org/journals/molecular-neuroscience/articles/10.3389/fnmol.2021.722396/full

  Postoperative radiotherapy (XRT) to a total dose of roughly 60 Gy over 30 fractions is recommended. […] The earliest reported results of the chemotherapy regimens, procarbazine, lomustine (CCNU), and vincristine (PCV), in AO were reported by Cairncross et al. (1994) and showed that the median time to progression for patients was at least 25.2 months for complete responders, 14.2 months for partial responders and 6.8 months for stable patients. […] Accordingly, the treatment approach is tailored according to the presence of 1p19q co-deletion, which characterizes oligodendrogliomas. Patients harboring co-deleted tumors can receive either PCV or TMZ. […] All in all, patients with 1p19q co-deleted tumors should be treated with RT and adjuvant PCV while those lacking this co-deletion should receive adjuvant TMZ. […] Recently, immunotherapy has been explored as a potential treatment modality. Elens et al. (2012) reported the survival benefit of immunotherapy in patients with relapsed AO enrolled in the HGG-IMMUNO-2003 trial.

• #36

  https://link.springer.com/article/10.1007/s11940-013-0218-9

  In cases without 1p19q deletion, most neuro-oncologists recommend incorporating radiotherapy into the upfront treatment strategy, typically combined with temozolomide as in glioblastoma. […] The optimal management of patients who have progressed after initial therapy is unclear and enrollment in clinical trials is recommended. […] Both PCV and temozolomide have activity in patients who have failed an initial chemotherapy regimen and could be considered as second line treatment. […] The optimal management of patients who have progressed after initial therapy is unclear and enrollment in clinical trials is recommended.

• #37 Clinical management of grade III oligodendroglioma | CMAR

  https://www.dovepress.com/clinical-management-of-grade-iii-oligodendroglioma-peer-reviewed-fulltext-article-CMAR

  If strong evidence now suggests that 1p/19q co-deleted AO/AOAs should be treated with adjuvant RT+CHT, no standard treatment is yet available for tumors without the 1p/19q co-deletion. […] In this type of tumor, disease recurrence is unfortunately the rule, and recurrences are typically local and often of a higher grade (ie, GBM). […] Several smaller studies using bevacizumab alone or in combination with other agents in patients with recurrent oligodendroglial tumors have suggested that bevacizumab is also active in these tumors. […] However, the exact impact of antiangiogenetic agents on the treatment of oligodendroglial tumors needs to be defined. […] Another treatment option that was recently reported in the literature includes the use of first-line dose-intense TMZ in patients with AO.

• #38 Oligodendroglioma – Symptoms, Diagnosis, TreatmentSecond Opinion IconGroup 9Second Opinion IconGroup 49

  https://www.barrowneuro.org/condition/oligodendroglioma/

  Anticonvulsants: If an oligodendroglioma has caused seizures, anti-seizure medications can be prescribed as supportive care. […] Corticosteroids: This class of medication can be used in the short term to help manage swelling around the tumor and relieve symptoms like headaches and nausea. […] At Barrow Neurological Institute’s world-class Brain and Spine Tumor Program, we treat people with complex tumors like oligodendrogliomas in one robust, full-service location. […] Clinical trials are part of the cancer research process to determine if new treatments are safe, effective, or even better than the current standard treatment.

• #39 Oligodendroglioma | Brain Tumor Center | Stanford Medicine

  https://med.stanford.edu/brain-tumor/conditions/glioma/oligodendroglioma.html

  Surgical resection, radiation therapy, and chemotherapy are the primary treatment options. […] If surgery is possible, aggressive resection can change the course of this disease for patients. For grade tumors 3, a combination of surgery, chemotherapy, and radiation are often required. […] Treatment also includes managing symptoms caused by the glioma. […] People who experience seizures are treated with an antiseizure drug, such as levetiracetam. Tumor-induced seizures can be challenging to treat, and surgical resection may be able to reduce seizure activity. […] Glucocorticoids (steroids) can improve headaches and neurologic deficits caused by cerebral edema. Dexamethasone is frequently prescribed for this purpose but is associated with significant side effects and may shorten survival. Glucocorticoids are used at the lowest effective dose and, ideally, only until other treatments are planned.

• #40 Specialized Programs for Oligodendroglioma Treatment | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/oligodendroglioma/specialized-programs-oligodendroglioma-treatment

  A patient with an oligodendroglioma should be seen by a multidisciplinary team at a major medical center, where experts in a wide range of specialists can attend to the many needs of patient, caregivers, and other family members. While surgery, chemotherapy, and radiation may be needed, we have found that our patients benefit from a more comprehensive approach. […] Integrative medicine recognizes the importance of treating the whole patient, including nutritional therapy, stress and grief management, and other emotional issues. An integrative medicine provider may recommend diet and exercise, yoga, acupuncture, or spiritual counseling. These have all been shown to improve quality of life during oligodendroglioma treatment. […] Pain management is a key component of oligodendroglioma treatment, since pain can significantly affect a patients quality of life. There is no need to suffer pain needlessly a pain management specialist has many options that offer relief, including medications, injections, and spinal cord stimulation.

• #41 Oligodendroglioma – Conditions – Neurooncology – Specialties – UR Neurosurgery – University of Rochester Medical Center

  https://www.urmc.rochester.edu/cancer-institute/cancers/brain-spine/multidisciplinary-care/neurosurgery/tumor-types/oligodendroglioma

  Low grade oligodendrogliomas are usually treated with a combination of surgery and radiation. If the tumor is located in an area where it is safe to remove, then your neurosurgeon will attempt to remove as much as possible, and sometimes this is all the treatment you will need at the beginning. Your doctors will monitor your tumor with MRI scans every few months and if the tumor appears to be growing, your doctors will then consider additional surgery or starting treatment with radiation. […] Anaplastic oligodendrogliomas are known for being very responsive to chemotherapy. For this reason, after surgery, patients will often receive a combination of radiation therapy and chemotherapy. At the University of Rochester, we are part of the Oligodendroglioma Study Group and depending on your type of tumor, you may be eligible for a clinical trial through this consortium.

• #42

  http://www.bccancer.bc.ca/books/neuro-oncology/management/oligodendroglioma

  Low grade oligodendrogliomas typically have slow growth patterns and a better prognosis than most gliomas. Treatment of asymptomatic biopsy-proven low grade oligodendrogliomas is controversial. Although adjuvant radiotherapy has been commonly advocated, there is evidence suggesting these lesions can be observed for clinical or radiographic progression without adversely affecting overall survival. In those with symptomatic residual disease after initial surgery, adjuvant radiotherapy is standard care and should be recommended. The role of adjuvant chemotherapy is currently under investigation. Although evidence exists that low grade oligodendrogliomas respond to chemotherapy, the impact on overall survival as compared to radiotherapy is unknown. Interest currently exists in treating patients with more indolent 1p/19q co-deleted with up-front chemotherapy. Recent evidence from the RTOG 9802 trial indicates higher risk low grade gliomas (age 40, incomplete resection) have longer survival with combinations of chemotherapy and radiotherapy.

• #43 Oligodendroglioma | The Brain Tumour Charity

  https://www.thebraintumourcharity.org/brain-tumour-diagnosis-treatment/types-of-brain-tumour-adult/oligodendroglioma/

  Detecting these genetic alterations with biomarker testing is now essential for diagnosis and when evaluating which treatments will be used for people who are diagnosed with an oligodendroglioma. […] The test is useful in diagnosing oligodendrogliomas and, therefore, in making decisions about the most appropriate treatment for you. […] For people with oligodendroglioma, the MGMT methylation test helps to predict how effective chemotherapy treatment is likely to be, although there are many other factors that also affect response to treatment. This can be used to help plan a suitable, individualised treatment plan. […] When found with 1p/19q co-deletion and IDH-mutant biomarkers, the TERT promoter mutation suggests a diagnosis of oligodendroglioma, and predicts greater benefit from chemotherapy and radiotherapy and longer survival, particularly in grade 2 and 3 gliomas.

• #44 Treatment Recommendations for Anaplastic Oligodendrogliomas That Are Codeleted

  https://www.cancernetwork.com/view/treatment-recommendations-anaplastic-oligodendrogliomas-are-codeleted

  Although important questions still remain regarding chemotherapy choice, sequence, and dosing, the answers to which will require additional large phase III trials, radiotherapy alone is no longer appropriate therapy for 1p/19q codeleted anaplastic oligodendrogliomas. […] The standard therapy for anaplastic gliomas (including both astrocytic and oligodendroglial tumors) has been radiotherapy, since clinical trials encompassing all anaplastic gliomas and evaluating treatment with chemotherapy alone or in combination with radiotherapy failed to show significantly different overall survival yet demonstrated additional toxicity. […] Patients with AOs with 1p/19q codeletion have now been shown to clearly benefit from frontline use of radiation therapy and chemotherapy. […] On the basis of these results, radiation alone is no longer considered adequate treatment for patients with AO containing 1p/19q codeletion. […] In conclusion, we believe, based on the current data, the postoperative standard-of-care treatment for patients with 1p/19q codeleted AO should be a combination of radiation and chemotherapy.

• #45

  http://www.bccancer.bc.ca/books/neuro-oncology/management/oligodendroglioma

  Initial treatment of oligodendroglioma is surgical. In feasible cases, gross total resection should be the goal. Pathology from surgery (biopsy or resection) should be reviewed. Oligodendrogliomas should be classified based on both histologic grade and molecular diagnostics. Histologically, oligodendrogliomas are classified by the WHO grading system as low grade (Gr. II) or anaplastic (Gr. III). Low grade tumours show increased cellularity but no anaplastic features of elevated mitotic rate, vascular proliferation or necrosis. Any of these features will lead to an anaplastic grading of the tumour. The molecular classification of oligodendroglioma divides these tumours into those showing co-deletion of chromosomes 1p and 19q and those with retention of those chromosome arms. Most tumours with 1p/19q co-deletion also show IDH1 mutation. Low grade tumours and those with 1p/19q co-deletion are good prognostic markers. In addition to a favorable prognosis, tumours with 1p/19q deletions show marked chemosensitivity (90%) and prolonged responses to radiotherapy.

• #46 Navigating oligodendroglioma medical care and journey

  https://www.oligonation.org/living-with-oligo/oligodendroglioma-treatments-and-options/

  Grade 3s are typically when radiation followed by chemotherapy is recommended. […] The identification of these mutations plays a role in prognosis and, more importantly, treatment options. […] You should confirm (and insist) that your neuro oncologist will have this genetic analysis done. […] Grade 2 Oligos are often put on watch and wait after surgery, though it is not uncommon to employ temodar post-surgery or if an apparent progression is noted. Grade 3 are usually treated with surgery, followed by radiation and chemooften a potent trio of agents known as PCV. […] Your prognosis and treatment plan can vary based on the grade and the mutations your tumor has.

• #47 Oligodendroglioma – brain tumour | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/brain-tumour/oligodendroglioma

  After surgery, the MDT will discuss whether further immediate treatment might be recommended. This may be radiotherapy, chemotherapy, or both. […] Radiotherapy uses high-energy x-rays to control or destroy the tumour cells. […] Chemotherapy uses anti-cancer drugs to destroy the tumour cells. If you have chemotherapy, a combination of drugs may be used. […] You may need treatment for the symptoms of an oligodendroglioma before you have any treatment for the tumour. […] Sometimes a brain tumour cannot be removed or may stop responding to treatment. If this happens, you can still have treatment for any symptoms. […] Clinical trials are a type of medical research involving people. They are important because they show which treatments are most effective and safe. […] After your treatment has finished, you will have regular check-ups, tests and scans. […] You may continue to have some side effects from treatment. […] If you have any symptoms or side effects you are worried about, you can also contact your doctor or nurse between appointments.

• #48 Anaplastic oligodendroglioma – Overview of Information and Clinical Research

  https://clinicaltrials.eu/disease/anaplastic-oligodendroglioma/

  For recurrent oligodendrogliomas, treatment options may include repeated surgery, radiation, chemotherapy, or participation in clinical trials. […] After initial treatment, regular monitoring through MRI scans is crucial to detect any tumor regrowth or new tumor development. […] The management of oligodendroglioma involves a comprehensive approach that integrates surgical, radiological, and pharmacological strategies. Surgery, often the first line of treatment, aims to remove as much of the tumor as possible while preserving neurological function. […] When complete resection is not feasible, radiation therapy serves as a critical adjunct, targeting residual tumor cells with precision. […] Chemotherapy, particularly with agents like temozolomide and the PCV regimen, plays a vital role in managing both initial and recurrent tumors, especially in the presence of favorable genetic markers such as 1p/19q co-deletion. […] The integration of targeted therapies and immunotherapies represents a promising frontier in treatment, aiming to improve outcomes while minimizing long-term side effects. […] Regular monitoring and follow-up are crucial for early detection of recurrence.

• #49

  https://medschool.cuanschutz.edu/neurosurgery/patientresources/conditions-and-diseases/oligodendroglioma

  Grade III oligodendroglioma: Surgical biopsy and removal of as much of the tumor as possible without causing serious neurological damage is the first step in the treatment of a grade III oligodendroglioma. Focal fractionated radiation in combination with chemotherapy are usually started 2-4 weeks after surgery. […] Long-term close follow-up with regular MRI scans is recommended to watch for tumor growth requiring further treatment.

• #50 Oligodendroglioma – NEURO

  https://neurosurgerycnj.com/brain/oligodendroglioma/

  In the case of anaplastic oligodendroglioma, radiation and chemotherapy are typically used in combination. If the tumor is recurrent (comes back), surgery in combination with chemotherapy is often recommended. […] Other treatments for oligodendroglioma include: Chemotherapy, Radiation, Clinical trials studying new treatments. […] Palliative care focuses on relieving symptoms caused by the tumor, but is not a treatment. […] Though completely eliminating the tumor or disease process is rare, oligodendroglioma has a higher brain cancer survival rate than most other brain tumors due to their slow growth and usually excellent response to treatment. Prolonging the life expectancy of someone with an oligodendroglioma is possible. […] Life expectancy depends on the grade of the tumor, how early it is diagnosed, its location and individual factors, such as comorbidities (other disease conditions present). Life expectancy statistics are not predictive as they do not account for individual factors, such as overall health.

• #51 Childhood Oligodendroglioma | Dana-Farber Cancer Institute

  https://www.dana-farber.org/cancer-care/types/childhood-oligodendroglioma

  Oligodendrogliomas are associated with a high cure rate. Following complete removal of the tumor, the chance of long-term survival is near 90 percent. If the tumor is not completely removed and radiation therapy is needed, the prognosis remains high, with survival rates ranging from 80 to 90 percent.

• #52 Updated: Exciting News for Patients with Grade 2 Oligodendroglioma and Astrocytoma

  https://braintumor.org/news/exciting-results-in-trial-for-grade-2-oligodendroglioma-and-astrocytoma-patients/

  Delaying the need for these toxic treatments means patients can live longer without experiencing some of the long-term complications from these treatments. […] Second, this represents the first time a targeted treatment was successfully developed specifically for this patient population. […] And now that its been shown that targeting IDH mutations in gliomas is an effective strategy, researchers and clinicians have the opportunity to explore more ways to leverage vorasidenib as well as other potential IDH-targeting drugs for additional glioma populations and in combinations with other treatments. […] Vorasidenib has not been approved by the FDA.

• #53

  https://link.springer.com/article/10.1007/s11060-022-04216-z

  For patients with CNS WHO grade 3 oligodendrogliomas two randomized controlled trials showed a survival benefit of administering PCV chemotherapy before or after radiotherapy following surgical resection. […] Ongoing clinical trials aim at improving the prognosis of patients with astrocytoma and oligodendroglioma and to reduce the burden of the therapy in patients with favorable prognosis. […] One common genetic hallmark of diffuse astrocytomas and oligodendrogliomas is the IDH-mutation, which is presented on the major histocompatibility complex (MHC) class II, making mutant IDH a potential target for immunotherapy and suitable for vaccination approaches. […] New targeted advances with small molecules and immunotherapies currently focus on addressing the IDH mutation, one of the genetic hallmarks of astrocytoma and oligodendroglioma.

• #54 A study looking at proton beam therapy for people with a brain tumour called oligodendroglioma (APPROACH) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/find-a-clinical-trial/a-study-looking-at-proton-beam-therapy-for-people-with-a-brain-tumour-called-oligodendroglioma

  In this study half the people will have standard radiotherapy and chemotherapy and the other half will have proton beam therapy and chemotherapy. […] The main aims of the study are to find out if using proton beam therapy means there are fewer long term neurocognitive side effects compared with standard radiotherapy, find out if people are willing to be part of a trial comparing these two treatments, and find out more about how the two treatments affect quality of life. […] Everyone has chemotherapy about one or two months after their standard radiotherapy or proton beam treatment has finished. This is standard treatment for oligodendroglioma. […] Everyone has PCV chemotherapy about one or two months after their radiotherapy or proton beam treatment has finished. This is standard treatment for oligodendroglioma.

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