دورية أكاديمية
أعرض في EDS

Radiation and chemotherapy for high-risk lower grade gliomas: Choosing between temozolomide and PCV.

التفاصيل البيبلوغرافية
العنوان: Radiation and chemotherapy for high-risk lower grade gliomas: Choosing between temozolomide and PCV.
المؤلفون: McDuff SGR; Department of Radiation Oncology, Duke Cancer Center, Medicine Circle, Durham, NC, USA., Dietrich J; Department of Neurology, Division of Neuro-Oncology, Massachusetts General Hospital, Boston, MA, USA., Atkins KM; Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA., Oh KS; Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA., Loeffler JS; Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA., Shih HA; Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA.
المصدر: Cancer medicine [Cancer Med] 2020 Jan; Vol. 9 (1), pp. 3-11. Date of Electronic Publication: 2019 Nov 07.
نوع المنشور: Journal Article; Review
اللغة: English
بيانات الدورية: Publisher: John Wiley & Sons Ltd Country of Publication: United States NLM ID: 101595310 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2045-7634 (Electronic) Linking ISSN: 20457634 NLM ISO Abbreviation: Cancer Med Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [Malden, MA] : John Wiley & Sons Ltd., c2012-
مواضيع طبية MeSH: Antineoplastic Combined Chemotherapy Protocols/*therapeutic use , Brain Neoplasms/*therapy , Chemoradiotherapy, Adjuvant/*methods , Glioma/*therapy , Temozolomide/*therapeutic use, Brain/pathology ; Brain/surgery ; Brain Neoplasms/genetics ; Brain Neoplasms/mortality ; Brain Neoplasms/pathology ; Chromosome Deletion ; Chromosomes, Human, Pair 1/genetics ; Chromosomes, Human, Pair 19/genetics ; Glioma/genetics ; Glioma/mortality ; Glioma/pathology ; Humans ; Isocitrate Dehydrogenase/genetics ; Lomustine/therapeutic use ; Mutation ; Neoplasm Grading ; Procarbazine/therapeutic use ; Progression-Free Survival ; Randomized Controlled Trials as Topic ; Vincristine/therapeutic use
مستخلص: Purpose: The majority of patients with high-risk lower grade gliomas (LGG) are treated with single-agent temozolomide (TMZ) and radiotherapy despite three randomized trials showing a striking overall survival benefit with adjuvant procarbazine, lomustine, and vincristine (PCV) chemotherapy and radiotherapy. This article aims to evaluate the evidence and rationale for the widespread use of TMZ instead of PCV for high-risk LGG.
Methods and Materials: We conducted a literature search utilizing PubMed for articles investigating the combination of radiotherapy and chemotherapy for high-risk LGG and analyzed the results of these studies.
Results: For patients with IDH mutant 1p/19q codeleted LGG tumors, there is limited evidence to support the use of TMZ. In medically fit patients with codeleted disease, existing data demonstrate a large survival benefit for PCV as compared to adjuvant radiation therapy alone. For patients with non-1p/19q codeleted LGG, early data from the CATNON study supports inclusion of adjuvant TMZ for 12 months. Subset analyses of the RTOG 9402 and EORTC 26951 do not demonstrate a survival benefit for adjuvant PCV for non-1p/19q codeleted gliomas, however secondary analyses of RTOG 9802 and RTOG 9402 demonstrated survival benefit in any IDH mutant lower grade gliomas, regardless of 1p/19q codeletion status.
Conclusions: At present, we conclude that current evidence does not support the widespread use of TMZ over PCV for all patients with high-risk LGG, and we instead recommend tailoring chemotherapy recommendation based on IDH status, favoring adjuvant PCV for patients with any IDH mutant tumors, both those that harbor 1p/19q codeletion and those non-1p/19q codeleted. Given the critical role radiation plays in the treatment of LGG, radiation oncologists should be actively involved in discussions regarding chemotherapy choice in order to optimize treatment for their patients.
(© 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
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فهرسة مساهمة: Keywords: PCV; chemotherapy; low grade glioma; radiotherapy; temozolomide
المشرفين على المادة: 35S93Y190K (Procarbazine)
5J49Q6B70F (Vincristine)
7BRF0Z81KG (Lomustine)
EC 1.1.1.41 (Isocitrate Dehydrogenase)
EC 1.1.1.42. (IDH1 protein, human)
YF1K15M17Y (Temozolomide)
تواريخ الأحداث: Date Created: 20191109 Date Completed: 20210119 Latest Revision: 20210119
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC6943166
DOI: 10.1002/cam4.2686
PMID: 31701682
قاعدة البيانات: MEDLINE
الوصف
تدمد:2045-7634
DOI:10.1002/cam4.2686