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Volume 12, Number 4, 2007

Postoperative treatment of patients with anaplastic oligodendrogliomas. Thirty years’ experience of the Maria Sklodowska-Curie Memorial Centre in Kraków, 1975–2000

Magdalena Ząbek, Bogdan Gliński, Jacek Urbański, Teresa Szpytma, Anna Mucha-Małecka, Elżbieta Pluta, Beata Frączek-Błachut


Background: Anaplastic oligodendrogliomas (AO) are infi ltrative, mostly supratentorial tumours, often bilaterally affecting the white matter. Radiotherapy alone or in combination
with chemotherapy have a role in the adjuvant treatment of AO, but currently the efficacy of various treatment modalities could not be definitively determined because of the heterogeneity of the therapies used.
Aim: Assessment of the effi cacy of altered therapy schedules in postoperative treatment
of patients with anaplastic oligodendrogliomas.
Materials/Methods: Between 1975 and 2000, 101 adult patients with anaplastic oligodendrogliomas were postoperatively treated in our institution. During this period patients received conventional radiation therapy and chemotherapy (CRT/CH), conventional
radiation therapy (CRT), and split course hypofractionated radiation therapy (SCHRT).
Between 1975 and 1985, CRT/CH was applied in 42 patients. Whole brain irradiation
was delivered; the tumour dose of 5Gy in 25 fractions over 5 weeks was calculated at the midplane of the skull. Then treatment fi elds were reduced and a 10Gy boost was given in 5 fractions over 5 days to the known tumour bearing area. On the last day of irradiation patients began the fi rst of six planned series of chemotherapy with CCNU, given 100mg/2, orally every 8 weeks. From 1986 to 1990, CRT was received by 27 patients. Irradiation was only as described above. Between 1991 and 2000, 32 patients were given SCHRT. There were 3 courses of irradiation separated by a one-month interval. In each of the two first series patients received 20Gy in 5 fractions in fi ve days to the whole brain, and in the third
course a 20Gy boost in 5 fractions over 5 days was given as in the CRT regimen.
Results: Actuarial overall survival rates at two and fi ve years were 38% and 10% respectively
for patients treated with CRT/CH, 36% and 11% for the CRT group, and 23% and 6% for the SCHRT option. Multivariate analysis revealed that only age was a significant factor. Patients aged 45 years or less carried the best prognosis.

Conclusions: The efficacy of different postoperative treatments administered to our patients
with anaplastic oligodendrogliomas gave approximately comparable and unrewarding
poor results.

Signature: Rep Pract Oncol Radiother, 2007; 12(4) : 217-223


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