Document Detail


Long-term outcome of low-grade oligodendroglioma and mixed glioma.
MedLine Citation:
PMID:  10751254     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Low-grade oligodendrogliomas and mixed gliomas can be indolent and remain unchanged for years. Optimal timing and effectiveness of initial treatment is uncertain and therapy can be associated with toxicity. METHODS: Retrospective review of patients diagnosed between 1979 and 1997 with low-grade oligodendroglioma or mixed glioma. Time to progression, survival, prognostic factors, and treatment toxicities were evaluated. RESULTS: A total of 106 patients (77 oligodendroglioma, 29 mixed glioma) were identified; median age was 36.7 years. Initial presenting symptoms were seizures in 76 (72%) and headache in 11 (10%); tumor was diagnosed as an incidental finding in five patients. Tumor progression was diagnosed in 72 patients (68%). Overall median time to progression (MTTP) was 5.0 years (range 0.5 to 14.2). Median overall survival (OS) was 16.7 years. No prognostic factors reached statistical significance. MTTP and OS were not significantly affected by treatment. Of 62 patients who received radiation therapy, 9 (15%) developed radiation necrosis and 13 developed radiation therapy-related cognitive changes, requiring ventriculoperitoneal shunting in six. Significant myelosuppression was seen in 35 of 76 (46%) patients treated with chemotherapy. CONCLUSIONS: Low-grade oligodendroglioma and mixed glioma have a long median overall survival. There were no apparent differences in either immediate versus deferred treatment or choice of initial therapy on disease-free or overall survival. Chemotherapy was associated with significant acute toxicity in almost one half of patients; radiation therapy produced late neurotoxicity in one third, justifying deferred treatment until clinically necessary.
Authors:
J D Olson; E Riedel; L M DeAngelis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurology     Volume:  54     ISSN:  0028-3878     ISO Abbreviation:  Neurology     Publication Date:  2000 Apr 
Date Detail:
Created Date:  2000-05-04     Completed Date:  2000-05-04     Revised Date:  2006-04-24    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1442-8     Citation Subset:  AIM; IM    
Affiliation:
Departments of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Antineoplastic Combined Chemotherapy Protocols / adverse effects,  therapeutic use
Brain Neoplasms / diagnosis,  mortality,  therapy*
Cisplatin / adverse effects,  therapeutic use
Cyclophosphamide / adverse effects,  therapeutic use
Disease-Free Survival
Female
Follow-Up Studies
Glioma / diagnosis,  mortality,  therapy*
Humans
Male
Middle Aged
Neoplasm Recurrence, Local / diagnosis*,  therapy
Neoplasms, Second Primary / diagnosis,  therapy
Oligodendroglioma / diagnosis,  mortality,  therapy*
Postoperative Complications
Radiotherapy, Adjuvant / adverse effects
Retrospective Studies
Survival Rate
Treatment Outcome
Vindesine / adverse effects,  therapeutic use
Chemical
Reg. No./Substance:
0/PCV regimen; 15663-27-1/Cisplatin; 50-18-0/Cyclophosphamide; 53643-48-4/Vindesine
Comments/Corrections
Comment In:
Neurology. 2000 Apr 11;54(7):1402-3   [PMID:  10751245 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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