Eighty percent survival rate at 15 years for 1p/19q co-deleted oligodendroglioma treated with upfront chemotherapy irrespective of tumor grade
Eighty percent survival rate at 15 years for 1p/19q co-deleted oligodendroglioma treated with upfront chemotherapy irrespective of tumor grade
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DOI：
10.1007/s11060-018-03027-5
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发表时间：
2019-01-01
影响因子：
3.9
通讯作者：
Higuchi, Yoshinori
中科院分区：
文献类型：
--
作者：
Iwadate, Yasuo;Matsutani, Tomoo;Higuchi, Yoshinori
前言：染色体1p/19q共缺失是一种诊断少突胶质细胞肿瘤的强有力的分子标志物，已被列入2016年WHO修订分类。尽管少突胶质瘤的治疗方法存在争议，但前期化疗被认为是低级别肿瘤的治疗选择之一。我们已经治疗了所有1p/19q联合缺失的少突胶质细胞瘤，包括II级和III级，20年来在没有常规放射治疗的情况下进行了预先化疗。本研究的临床经验对进一步了解1p/19q共缺失的少突胶质细胞瘤的生物学特性有一定的参考价值。共纳入70例患者，其中48例为II级肿瘤，22例为III级肿瘤。5年、10年和15年无进展生存率(PFS)分别为85.7%、54.8%和31.5%，中位PFS为146个月。在大多数情况下，肿瘤复发仍然是局部的，可以通过挽救手术和/或化疗来控制。5、10、15年总生存率(OS)分别为96.8%、88.7%、80.0%，未达到中位OS。这些生存数据与之前使用放射治疗的大型临床研究相比是有利的。基于世界卫生组织分类、手术范围和年龄的肿瘤分级既不影响PFS，也不影响OS。结论单机构20年的长期研究结果表明，1p/19q联合缺失的少突胶质细胞瘤患者可以在不影响OS的前提下成功地接受前期化疗。
Introduction Chromosomes 1p/19q co-deletion is a robust molecular marker for the diagnosis of oligodendroglial tumors, and has been included in the 2016 WHO modified classification. Although treatment for oligodendroglioma is controversial, upfront chemotherapy is regarded as one of the treatment option for low-grade tumor. We have treated all the 1p/19q co-deleted oligodendrogliomas, both grades II and III, with upfront chemotherapy without conventional radiotherapy for 20 years. The clinical experience from this trial may be suggestive for understanding of the biological features of oligodendroglioma with 1p/19q co-deletion toward precision medicine.Methods This is a long-term retrospective data of the non-selected patients with 1p/19q co-deleted oligodendrogliomas uniformly treated with up-front chemotherapy. Seventy consecutive patients (48 with grade II and 22 with grade III tumors) were included.Results The median follow-up period was 13 years. The 5-, 10-, and 15-year progression-free survival (PFS) rates were 85.7%, 54.8%, and 31.5%, respectively, and the median PFS was 146 months. In most cases, tumor recurrence was remained local and could be controlled by salvage surgery and/or chemotherapy. The 5-, 10-, and 15-year overall survival (OS) rates were 96.8%, 88.7%, and 80.0%, respectively, and the median OS was not reached. These survival data compared favorably with previous large clinical studies employing radiotherapy. Tumor grades based on World Health Organization classification, extent of surgery, and age affected neither PFS nor OS. Most patients were able to return to their premorbid social life.Conclusions The long-term results drawn from 20-years of single institution experience show that the patients with 1p/19q co-deleted oligodendrogliomas can be successfully treated with up-front chemotherapy alone without compromising OS.