Oligoastrocytoma medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Overview
The predominant therapy for oligoastrocytoma is surgical resection. Adjunctive chemotherapy and radiation are required. Supportive therapy for oligoastrocytoma includes anticonvulsants and corticosteroids.
Medical Therapy
The medical therapy of oligodendroglioma includes:
Radiotherapy
- Post-operative radiotherapy is recommended among all patients who develop oligoastrocytoma.[1][2][3]
- Radiotherapy may not cure the cancer but can control the tumor, delay recurrence, and increase survival.
- External beam radiation therapy is preferred to whole brain radiotherapy.[3]
- It may also be given as the main treatment, if surgery is not an option.
- External beam radiation therapy is usually administered in standard fractions of 1.8–2 grays (Gy) and can reach a total dose in the range of 60 Gy.[4]
Chemotherapy
- Chemotherapy is indicated as adjuvant therapy for oligoastrocytoma.[1][2][3]
- Temozolomide (Temodar) is the preferred drug for the treatment of oligoastrocytoma.[3][5]
- PCV 3 regimen is the preferred combination chemotherapy for oligoastrocytoma.[6]
- CCNU is administered on day 1, procarbazine is administered daily for 14 days beginning on day 8, and vincristine is administered on days 8 and 29 of each 6-week cycle of therapy.[7]
- Other chemotherapeutic drugs that may be used for the treatment of oligoastrocytoma include:[8]
- If oligoastrocytoma is unresponsive to the chemotherapeutic drugs used in earlier treatments or if it recurs, other drugs that may be used include:[8]
- The advanced mode of delivery of chemotherapeutic drugs to the brain include:[8]
- Intraventrical chemotherapy
- Interstitial chemotherapy
- Convection-enhanced delivery
Supportive treatment
Supportive therapy for oligoastrocytoma includes anticonvulsants and corticosteroids, which focuses on relieving symptoms and improving the patient’s neurologic function. The types of supportive therapy that may be used are:[3]
- Anticonvulsants
- Corticosteroids
- These drugs are used to reduce cerebral edema.
- The most commonly used corticosteroid is dexamethasone (Decadron).
References
- ↑ 1.0 1.1 Pouratian N, Schiff D (2010). "Management of low-grade glioma". Curr Neurol Neurosci Rep. 10 (3): 224–31. doi:10.1007/s11910-010-0105-7. PMC 2857752. PMID 20425038.
- ↑ 2.0 2.1 Chandana SR, Movva S, Arora M, Singh T (2008). "Primary brain tumors in adults". Am Fam Physician. 77 (10): 1423–30. PMID 18533376.
- ↑ 3.0 3.1 3.2 3.3 3.4 Treatment of mixed gliomas. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/brain-and-spinal-tumours/mixed-glioma/?region=on. Accessed on October 20, 2015
- ↑ Stupp R, Tonn JC, Brada M, Pentheroudakis G, ESMO Guidelines Working Group (2010). "High-grade malignant glioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up". Ann Oncol. 21 Suppl 5: v190–3. doi:10.1093/annonc/mdq187. PMID 20555079.
- ↑ Hoang-Xuan K, Capelle L, Kujas M, Taillibert S, Duffau H, Lejeune J; et al. (2004). "Temozolomide as initial treatment for adults with low-grade oligodendrogliomas or oligoastrocytomas and correlation with chromosome 1p deletions". J Clin Oncol. 22 (15): 3133–8. doi:10.1200/JCO.2004.10.169. PMID 15284265.
- ↑ Mueller W, Hartmann C, Hoffmann A, Lanksch W, Kiwit J, Tonn J; et al. (2002). "Genetic signature of oligoastrocytomas correlates with tumor location and denotes distinct molecular subsets". Am J Pathol. 161 (1): 313–9. doi:10.1016/S0002-9440(10)64183-1. PMC 1850690. PMID 12107116.
- ↑ Levin VA, Edwards MS, Wright DC, Seager ML, Schimberg TP, Townsend JJ; et al. (1980). "Modified procarbazine, CCNU, and vincristine (PCV 3) combination chemotherapy in the treatment of malignant brain tumors". Cancer Treat Rep. 64 (2–3): 237–44. PMID 7407756.
- ↑ 8.0 8.1 8.2 Chemotherapeutic drugs in malignant gliomas. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/treatment/chemotherapy/?region=on. Accessed on October 20, 2015