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Neoadjuvant temozolomide followed by complete resection of a 1p- and
19q-deleted anaplastic oligoastrocytoma: Case study
Alfredo D. Voloschin,
David N. Louis, Garth R. Cosgrove, and Tracy T. Batchelor
Departments of Neurology
(A.D.V., T.T.B.), Pathology (D.N.L.), and Neurosurgery (D.N.L.,
G.R.C.) and Cancer Center (D.N.L.), Massachusetts General Hospital and
Harvard Medical School, Boston, MA 02114, USA. Address correspondence
to Tracy Batchelor, Brain Tumor Center, Cox 315, Massachusetts General
Hospital, 55 Fruit Street, Boston, MA 02114, USA
(tbatchelor@partners.org).
A 38-year-old woman presented with an
infiltrative tumor of the right frontal lobe and genu of the corpus
callosum that was deemed only partially resectable.
A stereotactic biopsy was performed, which
revealed a right frontal oligoastrocytoma that had some anaplastic
features as well as allelic loss of chromosome arms 1p and 19q.
The patient was treated with temozolomide
for 24 months.
The partial response of the tumor to
chemotherapy rendered the lesion amenable to gross total resection,
which was performed subsequently.
The patient remains alive and well without
evidence of recurrence 7 months after resection and 48 months after
initial diagnosis.
Thus, preoperative chemotherapy decreased
tumor mass to a degree that subsequently enabled a gross total
resection.
This treatment strategy, although common
in the treatment of other solid tumors, is rarely utilized in adult
neuro-oncology and raises another potential role for chromosome
testing in oligodendroglial tumor management.
© 2005 Duke University Press
Source: http://hermia.ingentaselect.com/cgi-bin/linker?ini=dup_no&reqidx=/cw/dup/15228517/v7n1/s11/p97&user_id=undefined
DOI: http://dx.doi.org/10.1215/S1152851704000560
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