A Systematic Review For The Treatment Of Anaplastic Oligodendroglioma Chemotherapy Plus Radiotherapy Versus Radiotherapy Alone

Objective To assess systematically the the outcome of therapies and the prognostic factors for anaplastic oligodendroglioma. Methods We searched the largest medical literature data base in the world on line,and looked up the relevant Chinese and English neurosurgical journals. Randomized controlled trials and clinical controlled trials of chemotherapy for anaplastic oligodendroglioma were included. The quality of trials were critically assessed. RevMan 4.2.8 software was used for Meta analysis. Results Tow RCTs of chemotherapy plus radiotherapy versus radiotherapy alone for anaplastic oligodendroglioma were included. The results of meta-analysis showed that adjuvant procarbazine,lomustine,and vincristine for anaplastic oligodendroglioma increased the progression-free survival[OR=2.12,95%CI(1.50~2.99),P<0.0001]. More advantage of progression -free survival achieved in radiotherapy plus chemotherapy group. The difference of overall survival failed to show statistically significant between two protocols [OR=1.33,95%CI(0.98~1.81),P=0.07]. Prognostic factors: Combined loss of 1p/19q identifies a favorable subgroup of oligodendroglial tumors. [OR=5.65,95%CI (3.73~8.57),P<0.00001]and[OR=4.51,95%CI(2.95~6.90),P<0.00001]. RT/PCV did not improve OS but does increase PFS in the subgroup of patients with 1p/19q loss. [OR=1.19,95%CI(0.62~2.30),P=0.60]and PFS[OR=3.18,95%CI (1.69~5.98),P=0.0003]. Conclusions Compared with radiotherapy alone adjuvant PCV chemotherapy does not prolong OS but does increase PFS in anaplastic oligodendroglioma. Longer progression-free survival after PCV plus RT is associated with significant toxicity. Combined loss of 1p/19q identifies a favorable subgroup of oligodendroglial tumors. RT/PCV did not improve OS but does increase PFS in the subgroup of patients with 1p/19q loss.