Because of their chemosensitivity and the potential for radiation toxicity, low-grade oligodendroglioma are increasingly being treated with adjuvant or neoadjuvant chemotherapy before radiation therapy.
Full Answer
What is the role of chemotherapy in the treatment of oligodendroglioma?
Medical Care. 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) developed by Levin and coworkers. [9] Patients with pure and mixed oligoastrocytic tumors,...
How are IDH-mutated oligodendrogliomas treated?
As oligodendrogliomas are by definition IDH-mutated, investigations into IDH-targeted therapies have been undertaken. Enasidenib and ivosidenib are medications currently used for IDH-mutant acute myeloid leukemia. It is currently unclear how IDH mutations contribute to glioma formation and growth.
What are the treatment options for anaplastic oligodendroglioma?
Adjuvant procarbazine, lomustine, and vincristine chemotherapy in newly diagnosed anaplastic oligodendroglioma: long-term follow-up of EORTC brain tumor group study 26951. J. Clin. Oncol.31344–350. 10.1200/JCO.2012.43.2229 [PubMed] [CrossRef] [Google Scholar]
What is a Grade 2 oligodendroglioma?
Grade II oligodendrogliomas are low grade tumors. This means the tumor cells grow slowly and invade nearby normal tissue. In many cases, they form years before being diagnosed as no symptoms appear. Grade III oligodendrogliomas are malignant (cancerous). This means they are fast-growing tumors.
How is low grade glioma treated?
How can it be treated? Low grade gliomas are usually treated with a combination of surgery, observation, and radiation. If the tumor is located in an area where it is safe to remove, then the neurosurgeon will attempt to remove as much as possible.
What is the standard surgical of choice for low grade glioma?
Surgical Resection Surgery remains the mainstay of therapy for most low-grade gliomas. The best outcomes are associated with optimal surgical resection. One prospective study found a 5-year overall survival rate of 97% when the extent of resection exceeded 90%, vs 76% for tumors with lesser resection.
What is PCV chemotherapy?
PCV is a combination of the chemotherapy drugs procarbazine, lomustine (CCNU) and vincristine. It is used to treat brain tumours.
Can you cure a low grade glioma?
Most low-grade gliomas are both highly treatable and highly curable. The most common kind of low-grade glioma, called a pilocytic astrocytoma, has a cure rate over 90 percent.
Does low grade glioma come back after surgery?
Will a low grade glioma come back? In some cases, low grade gliomas, in particular Grade 2 gliomas, come back after surgery and treatment. This is called recurrent low grade glioma. To monitor for this, you will have regular imaging tests of your brain after treatment, and you will continue to follow up with our team.
How long does a low grade glioma take to grow?
How fast will a low grade glioma grow? Most LGG grow by 1—2% a year. Some people may have them for many years without being aware of them. The cause for a tumour is often unknown.
How is PCV chemotherapy given?
You take procarbazine capsules 3 times a day (some hospitals may give this on day 2 to 11). You have vincristine as a drip into your bloodstream (intravenously) over 10 minutes. You take lomustine as capsules at night.
How is BEP chemo administered?
How you have BEP. You have these drugs into your bloodstream, usually through a long line: a central line, a PICC line or a portacath. These are long, plastic tubes that give the drugs into a large vein in your chest. The tube stays in place throughout the course of your treatment.
What is an oligodendroglioma?
Oligodendroglioma is a primary central nervous system (CNS) tumor. This means it begins in the brain or spinal cord. To get an accurate diagnosis, a piece of tumor tissue will be removed during surgery, if possible. A neuropathologist should then review the tumor tissue.
Is low grade glioma malignant?
Low grade gliomas are benign (non-cancerous) tumours (grade I or II) that develop from brain cells called astrocytes.
What does a low grade glioma look like?
Low-grade gliomas are not very aggressive, but they cause a range of symptoms, many similar to faster-growing gliomas. Symptoms include blurry vision, headaches, memory loss, nausea and vomiting, numbness, sensory loss, and weakness on one side of the body.
What is a diffuse low grade glioma?
Diffuse low-grade gliomas (LLG) can be defined as tumors probably derived from glial cells and showing infiltrative growth and an absence of histological features of malignancy. They account for approximately 20% of all primary brain tumors and involve about 20,000 persons per year in the USA [1,2].
Chemotherapy
Chemotherapy is administered to shrink or eliminate brain tumors. Your chemotherapy regimen may include: 1
Radiation Therapy
Radiation therapy (radiotherapy) uses high doses of radiation to kill cancer cells and shrink or eliminate tumors.
Surgery
If the tumor is accessible, the first-line treatment for oligodendroglioma is surgery.
Over-the-Counter Therapies
Over-the-counter (OTC) medications may help reduce some of the symptoms of brain tumor, but they cannot treat or cure the tumor. OTC pain medications, such as Tylenol ( acetaminophen) or the nonsteroidal anti-inflammatory drugs (NSAIDs) Aleve (naproxen) and Advil ( ibuprofen ), may help provide relief from headaches.
Lifestyle
While home remedies and lifestyle choices will not cure oligodendroglioma, making healthy choices can help support your overall health and well-being, making your body as strong and healthy as possible to recover from treatment.
Complementary and Alternative Medicine (CAM)
Complementary and alternative medicine (CAM) is a possible way to relieve symptoms of certain health conditions.
Summary
Oligodendrogliomas are rare brain or spinal cord tumors. They are primarily treated with surgery, chemotherapy, and radiation therapy. There are other therapies available to help with symptom relief, like pain medication and alternative medicine.
What is the treatment for oligodendroglioma?
The role of chemotherapy for the treatment of oligodendroglioma was well established by several studies using nitrosourea-based therapy . {re8} Most used procarbazine, lomustine (CCNU), and vincristine, a combination chemotherapy regimen (ie, PCV) developed by Levin and coworkers. [ 9] Patients with pure and mixed oligoastrocytic tumors, newly diagnosed, and recurrent mixed tumors responded to this therapy before receiving radiotherapy. Despite prolonged responses, most patients experience disease relapse and ultimately die of progressive disease. The median time for recurrence was at least 16 months in partial responders and at least 25 months in complete responders. Recurrent tumors are not cured by PCV, and the intensity of treatment may be limited by the bone marrow reserve. [ 10]
What is the histologic image of oligodendroglioma?
This image shows monomorphous tumoral proliferation that consists of round, regular cells with a small, central, hyperchromatic nucleus surrounded by clear cytoplasm. Few calcifications are present.
How long does anaplastic oligodendroglioma last?
An interim analysis of a phase II study of intensified chemotherapy (I-PCV) alone for newly diagnosed anaplastic oligodendroglioma showed that median progression-free survival for all patients is 19.5 months, similar to the median progression-free survival for patients receiving radiotherapy alone in the RTOG and EORTC trials. These findings suggest that the patient care is not compromised by initiating treatment with chemotherapy alone and delay of radiotherapy may have a beneficial impact on quality of life. [ 12]
What is the chromatin appearance of an oligodendroglioma?
The chromatin appearance is finely threadlike to smudgy, often associated with pointlike basophilic chromocenters, rather than nucleoli.
Is temozolomide a second line?
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. The EORTC study evaluated temozolomide as a first-line chemotherapy for recurrent oligodendroglial tumors and showed a response rate of 54%, with 39% of patients remaining free from progression at 12 months. [ 11]
Can oligodendroglioma be treated with anticonvulsive therapy?
Because most patients either develop or present with seizures, anticonvulsive therapy is recommended once the patient is diagnosed with oligodendroglioma. See Brain Cancer Treatment Protocols for summarized information.
Can oligodendrogliomas be resectioned?
Historically, surgery has been the mainstay of treatment for oligodendrogliomas. The extent of resection depends in large part on the location of the tumor and its proximity to "eloquent" brain areas. If possible, the goal is total resection of the tumor. In patients who undergo total gross resection, no further treatment may be necessary, but the patient must be followed up for clinical or radiologic recurrence.