Phase III Trial of Chemoradiotherapy for Anaplastic Oligodendroglioma: Long-Term Results of RTOG 9402

• Type of Material: Article
• Authors: Gregory Cairncross, University of Calgary; Meihua Wang, American College of Radiology; Edward Shaw, Wake Forest University; Robert Jenkins, Mayo Clinic; David Brachman, Arizona Oncology Services Foundation; Jan Buckner, Mayo Clinic; Karen Fink, Baylor University; Luis Souhami, McGill University; Normand Laperriere, University of Toronto; Walter J Curran, Emory University; Minesh Mehta, Northwestern University
• Language: English
• Date: 2013-01-20
• Publisher: American Society of Clinical Oncology
• Publication Version: Final Published Version
• Copyright Statement: © 2012 by American Society of Clinical Oncology.
• Final Published Version (URL): http://dx.doi.org/10.1200/JCO.2012.43.2674
• Title of Journal or Parent Work: Journal of Clinical Oncology
• ISSN: 0732-183X
• Volume: 31
• Issue: 3
• Start Page: 337
• End Page: 343
• Grant/Funding Information: The study was also supported by a grant to the National Cancer Institute of Canada Clinical Trials Group from the Canadian Cancer Society.; Supported by Radiation Therapy Oncology Group Grants No. U10 CA21661 and U10 CA32115; North Central Cancer Treatment Group Grant No. U10 CA25224; Eastern Cooperative Oncology Group Grants No. CA17145 and CA21115; Southwest Oncology Group Grant No. CA32102; and Community Clinical Oncology Program Grant No. U10 CA37422, all from the National Cancer Institute.
• Keywords: Science & Technology; EUROPEAN-ORGANIZATION; TUMORS; PROCARBAZINE; Life Sciences & Biomedicine; OLIGOASTROCYTOMAS; SUCCESSFUL CHEMOTHERAPY; RADIOTHERAPY; VINCRISTINE; Oncology; INITIAL TREATMENT; AGGRESSIVE OLIGODENDROGLIOMA; TEMOZOLOMIDE
• Research Categories: Health Sciences, Oncology

Abstract

Purpose: Anaplastic oligodendrogliomas, pure (AO) and mixed (anaplastic oligoastrocytoma [AOA]), are chemosensitive, especially if codeleted for 1p/19q, but whether patients live longer after chemoradiotherapy is unknown Patients and Methods: Eligible patients with AO/AOA were randomly assigned to procarbazine, lomustine, and vincristine (PCV) plus radiotherapy (RT) versus RT alone. The primary end point was overall survival (OS) Results: Two hundred ninety-one eligible patients were randomly assigned: 148 to PCV plus RT and 143 to RT. For the entire cohort, there was no difference in median survival by treatment (4.6 years for PCV plus RT v 4.7 years for RT; hazard ratio [HR] = 0.79; 95% CI, 0.60 to 1.04; P =.1). Patients with codeleted tumors lived longer than those with noncodeleted tumors (PCV plus RT: 14.7 v2.6 years, HR = 0.36, 95% CI, 0.23 to 0.57, P <.001; RT: 7.3 v 2.7 years, HR = 0.40, 95% CI, 0.27 to 0.60, P <.001), and the median survival of those with codeleted tumors treated with PCV plus RT was twice that of patients receiving RT (14.7 v7.3 years; HR = 0.59; 95% CI, 0.37 to 0.95; P =.03). For those with noncodeleted tumors, there was no difference in median survival by treatment arm (2.6 v 2.7 years; HR = 0.85; 95% CI, 0.58 to 1.23; P =.39). In Cox models that ncluded codeletion status, the adjusted OS for all patients was prolonged by PCV plus RT (HR = 0.67; 95% CI, 0.50 to 0.91; P =.01) Conclusion: For the subset of patients with 1p/19q codeleted AO/AOA, PCV plus RT may be an especially effective treatment, although this observation was derived from an unplanned analysis.