The use of PCV chemotherapy in oligodendrogliomas

Oligodendrogliomas are now defined by the presence of whole-arm co-deletion in chromosomal arms 1p and 19q. The treatment paradigm for oligodendroglioma has shifted, owing to new diagnostic criteria and phase III clinical trial evidence. The treatment with radiation therapy plus chemotherapy with procarbazine, lomustine, and vincristine (PCV) results in prolongation of both progression-free and OS compared to treatment with radiation alone. Clinical trials, including RTOG 9402, EORTC 26951, and RTOG 9802, in contrast to NOA-04 and EORTC 22033, have conclusively demonstrated that chemoradiation is superior to either radiation therapy alone or chemotherapy alone for patients with oligodendroglioma. Regardless of grade, PCV chemotherapy, in addition to radiation, has a clear benefit in patients with oligodendroglioma and IDH mutated astrocytoma. Temozolomide may be less effective in the treatment of oligodendroglioma, but clearly has a benefit in astrocytoma.