Anaplastic oligodendroglial tumors harboring 1p/19q deletion can be successfully treated without radiotherapy.
Anaplastic oligodendroglial tumors harboring 1p/19q deletion can be successfully treated without radiotherapy.
复制标题
含有 1p/19q 缺失的间变性少突胶质细胞瘤无需放疗即可成功治疗。
作者：
Y. Iwadate;T. Matsutani;Natsuki Shinozaki;N. Saeki
虽然已知间变性少突胶质细胞瘤对化疗敏感，但在此诊断下的患者传统上采用放射治疗。为了避免可能的神经毒性，我们前瞻性地治疗了1 p/19 q缺失的间变性少突胶质细胞肿瘤患者，仅给予丙卡巴肼、ACNU和长春新碱化疗，而不进行放疗。25例患者入组研究（12例1 p/19 q共缺失，2例1 p单缺失，2例19 q单缺失，9例无1 p/19 q缺失）。所有患者的中位无进展生存期（PFS）为50个月，携带1 p/19 q缺失的肿瘤患者的无进展生存期明显长于未缺失的患者（p=0.0391）。有和无1 p/19 q缺失的两个患者组均未达到中位总生存期（OS）时间（p=0.230），所有患者的5年OS率为62.2%。出色的治疗结果证明了大规模临床研究的必要性，以确认前期化疗省略放疗作为1 p/19 q缺失的间变性少突胶质细胞肿瘤的初始治疗的有效性。
Although anaplastic oligodendroglial tumors are known to be chemosensitive, patients under this diagnosis have been traditionally treated with radiotherapy. To avoid possible neurotoxicity, we prospectively treated patients with anaplastic oligodendroglial tumors harboring 1p/19q deletion, with exclusive procarbazine, ACNU, and vincristine chemotherapy without radiotherapy. Twenty-five patients were enrolled in the study (12 with 1p/19q co-deletion, 2 with 1p mono-deletion, 2 with 19q mono-deletion, and 9 without 1p/19q deletion). The median progression-free survival (PFS) was 50 months for all the patients, and those with tumors harboring 1p/19q deletion were progression free for a significantly longer period than those without the deletion (p=0.0391). The median overall survival (OS) time was not reached in both patient groups with and without 1p/19q deletion (p=0.230), and the 5-year OS rate was 62.2% for all patients. The excellent treatment results warrant a large-scale clinical study to confirm the efficacy of upfront chemotherapy omitting radiotherapy as initial therapy for anaplastic oligodendroglial tumors with 1p/19q deletion.