Gonzalez-Aguilar A, Reyes-Moreno I, Peiro-Osuna R P, Hernandez-Hernandez A, Gutierrez-Aceves A, Santos-Zambrano J, Guerrero-Juarez V, Lopez-Martinez M, Castro-Martinez E
Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico DF, Mexico.
American British Cowdray Medical Center (ABC), Mexico DF, Mexico.
Rev Neurol. 2018 Oct 16;67(8):293-297.
Radiotherapy with procarbazine, lomustine, and vincristine (PCV) improves overall survival in patients with anaplastic oligodendroglioma 1p19q codeleted.
This retrospective analysis investigated outcomes in patients with anaplastic oligodendroglioma 1p19q codeleted compared two different protocols (radiotherapy plus temozolomide or PCV). The primary end points were overall survival and progression-free survival. Secondary endpoint was the radiological response.
A total of 48 patients were included. Mean age was 43 years (range: 19-66 years), 26 were male (54.1%). Twenty-one patients received PCV and 27 temozolomide. The baseline characteristics were not difference between the groups. The progression-free survival and overall survival in the PCV group were 7.2 and 10.6 years respectively and temozolomide were 6.1 and 9.2 years, both statistically significant. The radiological response was present in 80.9% in PCV arm and 70.2% in temozolomide arm there was not statistical differences. The multivariate Cox model showed only the significant parameters the use of PCV protocol. The toxicity grade 3 or 4 was present in 42.8% in PCV arm and 11.1% in temozolomide arm.
The most common strategy in the Latin America community is the substitution of the PCV for temozolomide. This retrospective study showed superior efficacy of PCV than temozolomide. The Latin American community effort must be made to be able to have the drugs to available for using as a first line of treatment.
丙卡巴肼、洛莫司汀和长春新碱（PCV）联合放疗可提高1p19q共缺失的间变性少突胶质细胞瘤患者的总生存率。
本回顾性分析调查了1p19q共缺失的间变性少突胶质细胞瘤患者的预后，比较了两种不同方案（放疗联合替莫唑胺或PCV）。主要终点是总生存率和无进展生存率。次要终点是放射学反应。
共纳入48例患者。平均年龄43岁（范围：19 - 66岁），男性26例（54.1%）。21例患者接受PCV治疗，27例接受替莫唑胺治疗。两组间基线特征无差异。PCV组的无进展生存率和总生存率分别为7.2年和10.6年，替莫唑胺组分别为6.1年和9.2年，均具有统计学意义。PCV组的放射学反应率为80.9%，替莫唑胺组为70.2%，无统计学差异。多变量Cox模型显示仅PCV方案的使用为显著参数。PCV组3级或4级毒性发生率为42.8%，替莫唑胺组为11.1%。
拉丁美洲群体最常见的策略是用替莫唑胺替代PCV。这项回顾性研究表明PCV的疗效优于替莫唑胺。拉丁美洲群体必须努力使这些药物能够作为一线治疗药物可用。
