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72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

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PCV chemotherapy alone for WHO grade 2 oligodendroglioma – prolonged disease control with low risk of malignant transformation

Initiale PCV-Chemotherapie in der Behandlung von Oligodendrogliomen WHO Grad 2 – verlängertes progressionsfreies Überleben und niedriges Risiko einer histologischen Malignisierung

Meeting Abstract

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  • presenting/speaker Jonathan Weller - LMU Medical Center of the University of Munich, Department of Neurosurgery, München, Deutschland
  • Sophie Katzendobler - LMU Medical Center of the University of Munich, Department of Neurosurgery, München, Deutschland
  • Philipp Karschnia - LMU Medical Center of the University of Munich, Department of Neurosurgery, München, Deutschland
  • Stefanie Lietke - LMU Medical Center of the University of Munich, Department of Neurosurgery, München, Deutschland
  • Rupert Egensperger - LMU Medical Center of the University of Munich, Department of Neuropathology, München, Deutschland
  • Niklas Thon - LMU Medical Center of the University of Munich, Department of Neurosurgery, München, Deutschland
  • presenting/speaker Michael Weller - Universitätsspital Zürich, Department of Neurology, Zürich, Schweiz
  • Bogdana Suchorska - LMU Medical Center of the University of Munich, Department of Neurosurgery, München, Deutschland
  • Jörg-Christian Tonn - LMU Medical Center of the University of Munich, Department of Neurosurgery, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocV213

doi: 10.3205/21dgnc206, urn:nbn:de:0183-21dgnc2064

Veröffentlicht: 4. Juni 2021

© 2021 Weller et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

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Objective: The role of chemotherapy alone in WHO grade 2 oligodendroglioma (OD) after biopsy, incomplete or gross total resection remains controversial. We here analyze the clinical outcome of four cohorts being treated with either procarbazine, CCNU and vincristine (PCV) or temozolomide (TMZ) compared to a wait and scan strategy and resection only.

Methods: 142 patients with molecular characterized OD (WHO 2016) were treated within four cohorts: (W&S) wait-and-scan after stereotactic biopsy (n=59); (RES) wait-and-scan after resection (n=27); (TMZ) temozolomide after biopsy (n=26) or (PCV) PCV (n=30) after biopsy. Presurgical MRI T2 tumor volumes were obtained by manual segmentation. Progression-free survival (PFS), post-recurrence PFS (PR-PFS) and rate of malignant transformation were analyzed.

Results: PFS was longest after PCV (9.1 years), compared to 5.1 years after W&S, 4.4 years after RES and 3.6 years after TMZ. The rate of malignant progression within 10 years was 9% in PCV, 29% in W&S, 67% in RES and 75% in TMZ (p=0.01). In W&S, patients treated with PCV at first relapse had a longer PFS from intervention than those treated with TMZ (7.2 vs 4.0 years, p = 0.04). Multivariate analysis identified smaller tumor volume prior to any intervention (p = 0.02) and initial PCV therapy (p=0.01) to be prognostic for progression-free survival.

Conclusion: PCV chemotherapy alone is an effective treatment option for WHO grade 2 oligodendroglioma with long PFS and low rate of malignant transformation.