Ruff Michael W, Buckner Jan C, Johnson Derek R, van den Bent Martin J, Geurts Marjolein
Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA.
Neurooncol Pract. 2019 Jan;6(1):17-21. doi: 10.1093/nop/npy044. Epub 2018 Nov 3.
The treatment of newly diagnosed oligodendroglioma has been revolutionized in the past decade by multiple studies demonstrating that the addition of chemotherapy to radiation therapy results in a significant survival benefit. While the most direct evidence comes from clinical trials that utilized PCV, a chemotherapy regimen consisting of procarbazine, CCNU (lomustine), and vincristine, there is circumstantial evidence suggesting that the oral agent temozolomide (TMZ), which is both better tolerated and logistically simpler than PCV, may also be effective. The lack of currently available direct comparative data for PCV vs TMZ results in a diversity of practice. In this article, Ruff and Buckner argue for PCV as part of the standard-of-care regimen for newly diagnosed anaplastic oligodendroglioma, while Geurts and van den Bent defend the use of TMZ.
在过去十年中，多项研究表明，在放射治疗中加入化疗可显著提高生存率，这彻底改变了新诊断少突胶质细胞瘤的治疗方法。虽然最直接的证据来自使用PCV（一种由丙卡巴肼、洛莫司汀和长春新碱组成的化疗方案）的临床试验，但有间接证据表明，口服药物替莫唑胺（TMZ），其耐受性优于PCV且在后勤方面更简便，可能也有效。目前缺乏PCV与TMZ的直接对比数据，导致了治疗方法的多样性。在本文中，拉夫和巴克纳主张将PCV作为新诊断间变性少突胶质细胞瘤标准治疗方案的一部分，而居尔茨和范登本特则支持使用TMZ。
