Yu Tosol, Kang Hyun-Cheol, Lim Do Hoon, Kim Il Han, Chung Woong-Ki, Suh Chang-Ok, Choi Byung Ock, Cho Kwan Ho, Cho Jae Ho, Kim Jin Hee, Park Chul-Kee, Hong Yong-Kil, Kim In Ah
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
J Neurooncol. 2015 Feb;121(3):531-9. doi: 10.1007/s11060-014-1660-6. Epub 2014 Nov 13.
This study investigated the treatment of anaplastic oligodendroglial tumors across nine Korean institutions. We reviewed the medical records from 381 patients with histologically confirmed anaplastic oligodendroglioma or anaplastic oligoastrocytoma (AOA) from 2000 to 2010. Clinical factors and treatment patterns were analyzed for each year. Post-operative therapy was performed in 354 patients (94.1 %), of which 133 received radiotherapy (RT) alone and 189 received both RT and chemotherapy. RT alone was the preferred treatment toward the end of the study period (29.4 % in 2000-2001 vs. 56.3 % in 2010, P = 0.005). The use of procarbazine, lomustine, and vincristine (PCV) decreased (57.6 % in 2000-2001 vs. 28.6 % in 2010, P = 0.001) and the use of temozolomide (TMZ) increased (0 % in 2000-2001 vs. 61.9 % in 2010, P < 0.001) over the study period. A combination of chemotherapy and RT was used more often than RT alone in young patients (P = 0.036) and patients with a good performance status (P = 0.023). The 1p/19q co-deletion status and O-6-methyguanine-DNA methyltransferase methylation were analyzed since 2004 but were not significant factors for determining whether to administer chemotherapy. Among the patients who received chemotherapy, TMZ was used more often in patients with AOA (P = 0.007) and PCV was used more often in patients with either multiple lesions (P = 0.027) or the 1p/19q co-deletion (P = 0.026). Our results demonstrate that the treatment pattern for oligodendroglial tumors changed significantly across the study period. In particular, TMZ has replaced PCV, and the use of molecular markers as well as RT alone has increased, but a unified protocol remains to be established.
本研究调查了韩国九家机构对间变性少突胶质细胞瘤的治疗情况。我们回顾了2000年至2010年381例经组织学确诊为间变性少突胶质细胞瘤或间变性少突星形细胞瘤（AOA）患者的病历。对每年的临床因素和治疗模式进行了分析。354例患者（94.1%）接受了术后治疗，其中133例仅接受放疗（RT），189例接受了放疗和化疗。在研究期结束时，单纯放疗是首选治疗方法（2000 - 2001年为29.4%，2010年为56.3%，P = 0.005）。在研究期间，丙卡巴肼、洛莫司汀和长春新碱（PCV）的使用减少（2000 - 2001年为57.6%，2010年为28.6%，P = 0.001），替莫唑胺（TMZ）的使用增加（2000 - 2001年为0%，2010年为61.9%，P < 0.001）。在年轻患者（P = 0.036）和身体状况良好的患者（P = 0.023）中，化疗和放疗联合使用的频率高于单纯放疗。自2004年起对1p/19q共缺失状态和O - 6 - 甲基鸟嘌呤 - DNA甲基转移酶甲基化进行了分析，但它们不是决定是否进行化疗的重要因素。在接受化疗的患者中，TMZ在AOA患者中使用更频繁（P = 0.007），PCV在有多个病灶（P = 0.027）或1p/19q共缺失（P = 0.026）的患者中使用更频繁。我们的结果表明，在整个研究期间，少突胶质细胞瘤的治疗模式发生了显著变化。特别是，TMZ已取代PCV，分子标志物的使用以及单纯放疗的使用都有所增加，但仍有待建立统一的方案。
