Oligoastrocytoma medical therapy

The predominant therapy for oligoastrocytoma is surgical resection. Adjunctive chemotherapy and radiation are required. Supportive therapy for oligoastrocytoma includes anticonvulsants and corticosteroids.

The medical therapy of oligodendroglioma includes:

• Post-operative radiotherapy is recommended among all patients who develop oligoastrocytoma.^[1][2][3]
• Radiotherapy may not cure the cancer but can control the tumor, delay recurrence, and increase survival.
• External beam radiation therapy is preferred to whole brain radiotherapy.^[3]
• It may also be given as the main treatment, if surgery is not an option.
• External beam radiation therapy is usually administered in standard fractions of 1.8–2 grays (Gy) and can reach a total dose in the range of 60 Gy.^[4]

• Chemotherapy is indicated as adjuvant therapy for oligoastrocytoma.^[1][2][3]
• Temozolomide (Temodar) is the preferred drug for the treatment of oligoastrocytoma.^[3][5]
• PCV 3 regimen is the preferred combination chemotherapy for oligoastrocytoma.^[6]
  • CCNU is administered on day 1, procarbazine is administered daily for 14 days beginning on day 8, and vincristine is administered on days 8 and 29 of each 6-week cycle of therapy.^[7]
• Other chemotherapeutic drugs that may be used for the treatment of oligoastrocytoma include:^[8]
  • Carmustine
  • Cisplatin
  • Erlotinib
  • Hydroxyurea
  • 6-thioguanine
  • Irinotecan
  • Methotrexate (intrathecally)
• If oligoastrocytoma is unresponsive to the chemotherapeutic drugs used in earlier treatments or if it recurs, other drugs that may be used include:^[8]
  • Tamoxifen
  • Carboplatin
  • Etoposide
• The advanced mode of delivery of chemotherapeutic drugs to the brain include:^[8]
  • Intraventrical chemotherapy
  • Interstitial chemotherapy
  • Convection-enhanced delivery

Supportive therapy for oligoastrocytoma includes anticonvulsants and corticosteroids, which focuses on relieving symptoms and improving the patient’s neurologic function. The types of supportive therapy that may be used are:^[3]

• Anticonvulsants
  • These drugs prevent seizures.
  • They are given to people who have had a previous seizure.
  • The most commonly used anticonvulsant is phenytoin (Dilantin).
• Corticosteroids
  • These drugs are used to reduce cerebral edema.
  • The most commonly used corticosteroid is dexamethasone (Decadron).

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