Abstract
We analyzed clinical data of 376 patients with histologically confirmed anaplastic oligodendroglioma or anaplastic oligoastrocytoma (AOA) from 2000 to 2010. Post-operative therapy was performed in 354 patients (94.1 %), of which 133 received radiotherapy (RT) alone and 189 received both RT and chemotherapy. The use of procarbazine, lomustine, and vincristine (PCV) decreased (57.6 % in 2000-2001 vs. 28.6 %in 2010) and the use of temozolomide (TMZ) increased (0 % in 2000-2001 vs. 61.9 % in 2010) over the study period. A combination of chemotherapy and RT was used more often than RT alone in young patients and patients with a good performance status. The 1p/19q co-deletion status and O-6-methyguanine-DNA methyltransferase methylation were analyzed since 2004. Among the patients who received chemotherapy, TMZ was used more often in patients with AOA and PCV was used more often in patients with the 1p/19q codeletion. Median progression-free survival (PFS) was 2.9 years and overall survival (OS) was 8.7 years. (5-year and 10-year OS rates were 58% and 45%, 5-year and 10-year PFS rates were 38% and 24%). Younger age, frontal lobe location of the tumor, gross total removal, 1p/19q codeletion, and initial RT were associated with longer PFS and OS rates. A clear improvement in progression-free and overall survival was observed for RT and combined CT/RT in compared with CT only. Postoperative RT appears to improve survival for entire group thus total removal and 1p/19q codeletion may not be sufficient criteria to omit RT as a treatment option. These results suggest that RT should continue to be offered as the standard treatment option. Taken together, treatment pattern for oligodendroglial tumors changed significantly across the study period in Korea. In particular, TMZ has replaced PCV, and the use of molecular markers as well as RT alone has increased, but a optimal therapeutic option remains to be defined though the prospective randomized studies.
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