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Medical Neuro-Oncology |
Departments of Neurology (A.D.V., T.T.B.), Pathology (D.N.L.), and Neurosurgery (D.N.L., G.R.C.) and Cancer Center (D.N.L.), Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
2 Address correspondence to Tracy Batchelor, Brain Tumor Center, Cox 315, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA (tbatchelor{at}partners.org).
Abstract
A 38-year-old woman presented with an infiltrative tumor of the right frontal lobe and genu of the corpus callosum that was deemed only partially resectable. A stereotactic biopsy was performed, which revealed a right frontal oligoastrocytoma that had some anaplastic features as well as allelic loss of chromosome arms 1p and 19q. The patient was treated with temozolomide for 24 months. The partial response of the tumor to chemotherapy rendered the lesion amenable to gross total resection, which was performed subsequently. The patient remains alive and well without evidence of recurrence 7 months after resection and 48 months after initial diag-nosis. Thus, preoperative chemotherapy decreased tumor mass to a degree that subsequently enabled a gross total resection. This treatment strategy, although common in the treatment of other solid tumors, is rarely utilized in adult neuro-oncology and raises another potential role for chromosome testing in oligodendroglial tumor management.
References
Cairncross, J.G., and Macdonald, D.R. (1988) Successful chemotherapy for recurrent malignant oligodendroglioma. Ann. Neurol. 23,360 -364.[CrossRef][ISI][Medline]
Cairncross, J.G., Ueki, K., Zlatescu, M.C., Lisle, D.K.,
Finkelstein, D.M., Hammond, R.R., Silver, J.S., Stark, P.C., Macdonald, D.R.,
Ino, Y., Ramsay, D.A., and Louis, D.N. (1998) Specific genetic
predictors of chemotherapeutic response and survival in patients with
anaplastic oligodendrogliomas. J. Natl. Cancer Inst.
90,1473
-1479.
Chahlavi, A., Kanner, A., Peereboom, D., Staugaitis, S.M., Elson, P., and Barnett, G. (2003) Impact of chromosome 1p status in response of oligodendroglioma to temozolomide: Preliminary results. J. Neurooncol. 61,267 -273.[CrossRef][Medline]
Deo, S.V., Bhutani, M., Shukla, N.K., Raina, V., Rath, G.K., and Purkayasth, J. (2003) Randomized trial comparing neo-adjuvant versus adjuvant chemotherapy in operable locally advanced breast cancer (T4b N0-2 M0). J. Surg. Oncol. 84,192 -197.[CrossRef][ISI][Medline]
Engelhard, H.H., Stelea, A., and Mundt, A. (2003) Oligodendroglioma and anaplastic oligodendroglioma: Clinical features, treatment, and prog nosis. Surg. Neurol. 60,443 -456.[CrossRef][ISI][Medline]
Glass, J., Hochberg, F.H., Gruber, M.L., Louis, D.N., Smith, D., and Rattner, B. (1992) The treatment of oligodendrogliomas and mixed oligodendro glioma-astrocytomas with PCV chemotherapy. J. Neurosurg. 76,741 -745.[ISI][Medline]
Ino, Y., Betensky, R.A., Zlatescu, M.C., Sasaki, H., Macdonald,
D.R., Stemmer-Rachamimov, A.O., Ramsay, D.A., Cairncross, J.G., and Louis,
D.N. (2001) Molecular subtypes of anaplastic oligodendroglioma:
Implications for patient management at diagnosis. Clin. Cancer
Res. 7,839
-845.
Kim, L., Hochberg, F.H., Thornton, A.F., Harsh, G.R., 4th, Patel, H., Finkel stein, D., and Louis, D.N. (1996) Procarbazine, lomustine, and vincris tine (PCV) chemotherapy for grade III and grade IV oligoastrocytomas. J. Neurosurg. 85,602 -607.[ISI][Medline]
Macdonald, D.R., Gaspar, L.E., and Cairncross, J.G. (1990) Successful che motherapy for newly diagnosed aggressive oligodendroglioma. Ann. Neurol. 27,573 -574.[CrossRef][ISI][Medline]
Reifenberger, G., and Louis, D.N. (2003) Oligodendroglioma: Toward molecular definitions in diagnostic neuro-oncology. J. Neuropathol. Exp. Neurol. 62,111 -126.[ISI][Medline]
Sasaki, H., Zlatescu, M.C., Betensky, R.A., Johnk, L.B., Cutone, A.N., Cairncross, J.G., and Louis, D.N. (2002) Histopathological-molecular genetic correlations in referral pathologist-diagnosed low-grade "oligodendroglioma." J. Neuropathol. Exp. Neurol. 61,58 -63.[ISI][Medline]
Shamberger, R.C., LaQuaglia, M.P., Gebhardt, M.C., Neff, J.R., Tarbell, N.J., Marcus, K.C., Sailer, S.L., Womer, R.B., Miser, J.S., Dickman, P.S., Perlman, E.J., Devidas, M., Linda, S.B., Krailo, M.D., Grier, H.E., and Granowetter, L. (2003) Ewing sarcoma/primitive neuroectodermal tumor of the chest wall: Impact of initial versus delayed resection on tumor margins, survival, and use of radiation therapy. Ann. Surg. 238,563 -568.[ISI][Medline]
Smith, J.S., Perry, A., Borell, T.J., Lee, H.K., O'Fallon, J.,
Hosek, S.M., Kimmel, D., Yates, A., Burger, P.C., Scheithauer, B.W., and
Jenkins, R.B. (2000) Alterations of chromosome arms 1p and 19q as
predictors of survival in oligodendrogliomas, astrocytomas, and mixed
oligoastrocytomas. J. Clin. Oncol.
18,636
-645.
Valera, E.T., Serafíni, L.N., Machado, H.R., and Tone, L.G. (2003) Complete surgical resection in children with low-grade astrocytomas after neo-adjuvant chemotherapy. Childs Nerv. Syst. 19,86 -90.[ISI][Medline]
van den Bent, M.J., Taphoorn, M.J., Brandes, A.A., Menten, J.,
Stupp, R., Frenay, M., Chinot, O., Kros, J.M., van der Rijt, C.C., Vecht,
Ch.J., Allgeier, A., and Gorlia, T. (2003a) Phase II study of
first-line chemotherapy with temozolomide in recurrent oligodendroglial
tumors: The European Organization for Research and Treatment of Cancer Brain
Tumor Group Study 26971. J. Clin. Oncol.
21,2525
-2528.
van den Bent, M., Chinot, O.L., and Cairncross, J.G. (2003b) Recent devel opments in the molecular characterization and treatment of oligodendroglial tumors. Neuro-Oncol. 5, 128-138.[Abstract]
Zlatescu, M.C., Tehrani Yazdi, A., Sasaki, H., Megyesi, J.F.,
Betensky, R.A., Louis, D.N., and Cairncross, J.G. (2001) Tumor
location and growth pattern correlate with genetic signature in
oligodendroglial neoplasms. Cancer Res.
61,6713
-6715.
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