PC or PCV, That Is the Question: Primary Anaplastic Oligodendroglial Tumors Treated with Procarbazine and CCNU With and Without Vincristine.

Abstract

BACKGROUND:

While procarbazine with 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (PC) added to vincristine (PCV) was proven beneficial in the treatment of co-deleted anaplastic oligodendroglioma (AO), the question of whether PC alone is sufficient is important, as vincristine adds toxicity with uncertain benefit. This retrospective study provides a comparison of PC and PCV.

PATIENTS AND METHODS:

Patients diagnosed with AO treated at the M.D. Anderson Cancer Center from June 1, 1993 to October 13, 2009 were selected from the database and were eligible if diagnosed with a primary AO and treated with either PC or PCV at some point. Ninety-seven patients were treated with such chemotherapy before first progression.

RESULTS:

Initial treatment included radiation and chemotherapy (81.4%) or chemotherapy alone (18.6%). Twenty-one patients (21.6%) received PC during primary treatment, while 76 patients (78.4%) received PCV. Eleven patients reported neurotoxicity in the PCV arm vs. none in the PC arm. Out of the 97 patients, 45 were alive at last contact, with a median follow-up of 9.9 years. The median overall survival was 6.5 years (95% confidence interval=4.8-16.7 years), while the median progression-free survival was 2.9 years (95% confidence interval=2.0-6.3 years); these differences were not significant (p=0.61 and p=0.28, respectively).

CONCLUSION:

Initial therapy with PC achieved comparable results to those of PCV with a median follow-up of 9.9 years. Neurotoxicity was more frequent with vincristine. Although selecting only for patients with AO, rather than those with mixed histology, increased the likelihood of selecting for patients with tumors with co-deletions, further studies with correlative co-deletion status are required.

• Authors: Courtney Webre, Nicole Shonka, Lynette Smith, Diane Liu, John De Groot
• Journal: Anticancer research (Anticancer Res) Vol. 35 Issue 10 Pg. 5467-72 (Oct 2015) ISSN: 1791-7530 [Electronic] Greece
• PMID: 26408710 (Publication Type: Clinical Study, Comparative Study, Journal Article)
• Copyright: Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Chemical References

• Antineoplastic Agents
• Procarbazine
• Vincristine
• Lomustine

Topics

• Adolescent
• Adult
• Aged
• Antineoplastic Agents (administration & dosage, therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols
• Astrocytoma (drug therapy, pathology)
• Brain Neoplasms (drug therapy, pathology)
• Female
• Humans
• Lomustine (administration & dosage, adverse effects, therapeutic use)
• Male
• Middle Aged
• Oligodendroglioma (drug therapy, pathology)
• Procarbazine (administration & dosage, adverse effects, therapeutic use)
• Retrospective Studies
• Survival Analysis
• Treatment Outcome
• Vincristine (administration & dosage, therapeutic use)
• Young Adult