P12.44.A ADJUVANT CHEMORADIOTHERAPY WITH PROCARBAZINE, LOMUSTINE, AND VINCRISTINE (PCV) OR TEMOZOLOMIDE FOR 1P/19Q CO-DELETED ANAPLASTIC OLIGODENDROGLIOMA: A NETWORK META-ANALYSIS
Bibliographic record
Abstract
Abstract BACKGROUND Anaplastic oligodendrogliomas (IDH-mutant and 1p/19q-codeleted) are rare diffuse gliomas characterized by favorable responses to chemoradiotherapy. Although radiotherapy (RT) combined with procarbazine, lomustine, and vincristine (PCV) has been the historical standard, temozolomide (TMZ) has been increasingly used due to its more favorable toxicity profile. However, direct comparisons between these regimens are limited. To compare the efficacy of RT combined with PCV versus RT combined with TMZ in adult patients with anaplastic oligodendroglioma characterized by confirmed 1p/19q co-deletion by conducting a network meta-analysis (NMA). MATERIAL AND METHODS A systematic search of PubMed, Embase, and the Cochrane Library was conducted up to March 2025. Eligible studies included patients with 1p/19q-codeleted anaplastic oligodendroglioma treated with RT+PCV, RT+TMZ, or RT alone. Both randomized trials, prospective, and retrospective cohorts were included. Studies comparing RT alone to RT+PCV or RT+TMZ were used to create indirect comparisons, with RT as a common comparator. A frequentist network meta-analysis with a random-effects model estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS) and progression-free survival (PFS). Consistency and heterogeneity were assessed using standard statistical methods. RESULTS Eight studies comprising 2,416 patients were included. In the network meta-analysis, compared with RT alone, RT+PCV significantly improved OS (HR: 0.617; 95% CI 0.465- 0.819; p = 0.0009), and PFS (HR: 0.547; 95% CI 0.415- 0.721; p < 0.0001), while RT+TMZ showed a trend toward improved OS (HR: 0.913; 95% CI 0.666- 1.252; p = 0.421) and PFS (HR: 1.270; 95% CI 0.870- 1.855; p = 0.215), without statistical significance. These comparisons with RT alone were included to establish the network structure. The primary objective of the study was the direct and indirect comparison between RT+PCV and RT+TMZ, in which RT+PCV demonstrated superior OS (HR: 0.676; 95% CI, 0.585-0.781; p < 0.0001) and better PFS (HR: 0.431; 95% CI, 0.325-0.570; p < 0.0001). Network consistency was confirmed (p > 0.1), (Q_between = 0.44; p = 0.506) to OS and (Q_between = 0.02; p = 0.8818) to PFS. CONCLUSION In patients with 1p/19q-codeleted anaplastic oligodendroglioma, RT combined with PCV provides superior survival outcomes compared to radiotherapy combined with TMZ. These findings support the continued use of PCV as the preferred chemoradiotherapy regimen when feasible, while emphasizing the need for future randomized trials to validate these results.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.011 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.012 | 0.044 |
| Bibliometrics | 0.004 | 0.005 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".