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Oligodendroglioma — SCE Medical Oncology MCQ

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HardCNS TumoursOligodendrogliomaSCE Medical Oncology

A 45-year-old woman with a grade 2 oligodendroglioma (IDH-mutant, 1p/19q co-deleted) undergoes maximal safe resection. What adjuvant therapy is standard of care?

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Correct answer: B — Radiotherapy followed by PCV chemotherapy (procarbazine, CCNU, vincristine)

For grade 2-3 oligodendroglioma (IDH-mutant, 1p/19q co-deleted), the RTOG 9802 and EORTC 26951 trials established radiotherapy followed by PCV chemotherapy as the standard of care, demonstrating significant OS benefit (>14 years median OS). The 1p/19q co-deletion is both diagnostic and a strong favourable prognostic/predictive biomarker. While temozolomide is often substituted for PCV in practice (CODEL trial ongoing), PCV remains the evidence-based standard.

Reference: NICE NG99 Brain tumours in adults; ESMO 2024 CNS Tumour Guidelines; RTOG 9802; van den Bent et al NEJM 2006