Treatment Outcomes in 1p19q Co-deleted/Partially Deleted Gliomas.

Autor:	McNamara MG; 1Department of Medical Oncology,Princess Margaret Cancer Centre,Toronto,Canada., Jiang H; 3Department of Biostatistics,Princess Margaret Cancer Centre,Toronto,Canada., Lim-Fat MJ; 1Department of Medical Oncology,Princess Margaret Cancer Centre,Toronto,Canada., Sahebjam S; 4Department of Medical Oncology,Moffitt Cancer Centre,Tampa,Florida., Kiehl TR; 5Department of Pathology,University Health Network,Toronto,Canada., Karamchandani J; 6Department of Pathology,St. Michael's Hospital,Toronto,Canada., Coire C; 7Department of Pathology,Trillium Health Centre,Mississauga,Canada., Chung C; 8Department of Radiation Oncology,Princess Margaret Cancer Centre/University of Toronto,Canada., Millar BA; 8Department of Radiation Oncology,Princess Margaret Cancer Centre/University of Toronto,Canada., Laperriere N; 8Department of Radiation Oncology,Princess Margaret Cancer Centre/University of Toronto,Canada., Mason WP; 1Department of Medical Oncology,Princess Margaret Cancer Centre,Toronto,Canada.
Jazyk:	angličtina
Zdroj:	The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques [Can J Neurol Sci] 2017 May; Vol. 44 (3), pp. 288-294.
DOI:	10.1017/cjn.2016.420
Abstrakt:	Background: Radiotherapy with procarbazine, lomustine, and vincristine improves overall survival (OS) in patients with 1p19q co-deleted anaplastic oligodendroglioma/anaplastic oligoastrocytoma. Methods: This retrospective analysis investigated outcomes in patients with 1p19q co-deleted/partially deleted oligodendroglioma, oligoastrocytoma, anaplastic oligodendroglioma, or anaplastic oligoastrocytoma. OS and progression-free survival (PFS) were analyzed using the Kaplan-Meier method and prognostic factors using the Cox proportional hazard model. Results: A total of 106 patients (between December 1997 and December 2013) were included. Median age was 40 years (19-66), 58 were male (55%), Eastern Cooperative Oncology Group performance status was 0 in 80 patients (75%). 1p19q status was co-deleted in 66 (62%), incompletely co-deleted in 27 (25%), and 1p or 19q loss alone in four (4%) and nine (8%) patients, respectively. Isocitrate dehydrogenase-1 R132H mutation was found in 67 of 85 patients with sufficient material. Upfront treatment was given in 72 (68%) patients and temozolomide alone in 52 (49%). Median time to radiotherapy in 47 patients (44%) was 34.7 months and 41.2 months in 9 patients with co-deleted/incompletely co-deleted anaplastic oligodendroglioma/anaplastic oligoastrocytoma who received upfront temozolomide alone. Median OS was not reached and 5-year OS was 91% for all groups (median follow-up, 5.1 years). On multivariable analysis for all patients, receipt of therapy upfront versus none (p=0.04), PS 1 versus 0 (p<0.001) and 1p19q co-deletion/incomplete deletion versus 1p or 19q loss alone (p=0.005) were prognostic for PFS. Isocitrate dehydrogenase-1 status was not prognostic for PFS. Conclusions: With similar survival patterns in low-grade/anaplastic gliomas, molecular characteristics may be more important than histological grade. Longer follow-up and results of prospective trials are needed for definitive guidance on treatment of these patients.
Databáze:	MEDLINE
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