PCV for oligodendroglial tumors: In search of prognostic factors for response and survival

被引:28
作者
Fortin, D
Macdonald, DR
Stitt, L
Cairncross, JG
机构
[1] Univ Sherbrooke, CUSE, Dept Neurosurg, Sherbrooke, PQ J1H 5N4, Canada
[2] Univ Sherbrooke, Ctr Univ Sante Estrie, Dept Neurooncol, Sherbrooke, PQ J1K 2R1, Canada
[3] Univ Western Ontario, Dept Oncol, London, ON, Canada
[4] Univ Western Ontario, Dept Clin Neurol Sci, London, ON, Canada
[5] London Reg Canc Ctr, Dept Biometry & Outcome Measurement, London, ON N6A 4L6, Canada
关键词
D O I
10.1017/S0317167100001359
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: We report survival and pretreatment prognostic factors for survival and chemosensitivity in 53 oligodendrogliomas treated with PCV (procarbazine, lomustine and vincristine) chemotherapy. Methods: A total of 53 patients with histologically proven oligodendroglioma, anaplastic oligodendroglioma or oligo-astrocytoma and treated with PCV were extracted from the London Regional Cancer Center database. A retrospective review was conducted to evaluate overall survival and pretreatment prognostic factors for survival and chemosensitivity. Results: The median survival time from diagnosis was 123.6 months. The overall five- and ten-year survival rates were 72.7% and 52.7% respectively. Age < 40, seizure as an initial symptom, absence of cognitive deficit and presence of a homogeneous hypodense lesion without contrast enhancement on the initial pretreatment CT scan were all factors independently associated with favorable outcome. The presence of increased cellularity, pleomorphism, mitosis, vascular proliferation and grading as an anaplastic lesion using these surrogates on pathological assessment, were all associated with an unfavorable outcome in univariable. analysis. In multivariable analysis, only the anaplastic grading and presence of increased cellularity were significant determinants of unfavorable survival. The only factor adversely associated with chemosensitivity was the presence of a focal symptom at presentation. Conclusion: Overall survival is significantly longer in oligodendroglial lesions than in fibrillary astrocytic tumors. A two tier grading system using standard morphological features seems accurate in predicting outcome in these patients. The presence of a neoplastic astrocytic component does not seem to impact the outcome. No clinical, radiological or pathological factor could be identified to reliably predict chemotherapy response.
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页码:215 / 223
页数:9
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