Oligodendroglioma and anaplastic oligodendroglioma: Clinical features, treatment, and prognosis

BACKGROUND Recent advances that have been made in diagnostic imaging, surgical technique, chemotherapy, molecular biology, and prediction of therapeutic response could have potential impact on the optimal diagnosis and treatment of patients with brain tumors, especially those with oligodendrogliomas. In this article, the topic of oligodendroglioma and anaplastic oligodendroglioma is reviewed, highlighting the new clinical developments. METHODS Information for this review was obtained by performing a Medline search for recent references using the term "oligodendroglioma." The bibliographies of papers obtained also were checked for articles that could provide additional understanding of this disease and its current treatment. RESULTS The incidence of oligodendroglioma is increasing, most likely due to its improved recognition. Seizures and/or headaches are still common presenting features, and surgery continues to be the primary treatment. Positron emission tomography (PET) and molecular analysis of the surgical specimen are emerging as important diagnostic tools. Patients having either oligodendroglioma or anaplastic oligodendroglioma are likely to respond to chemotherapy. This has had an impact upon the timing of radiation therapy. Survival times are increasing, and patients can now be divided into prognostic subgroups based on the molecular features of their tumors. While proconbazine-CCNU-vincristine (PCV) chemotherapy has been the standard, other agents, notably temozolomide, are currently being tested. CONCLUSIONS The algorithm for diagnosing and treating patients with oligodendrogliomas has changed. Neurosurgeons need to be aware of the new developments so they can offer sound advice to their patients. (C) 2003 Elsevier Inc. All rights reserved.