Adjuvant chemoradiotherapy with procarbazine, lomustine, and vincristine (PCV) or temozolomide for 1p/19q Co-deleted anaplastic oligodendroglioma: a systematic review and network meta-analysis
Bibliographic record
Abstract
INTRODUCTION: Anaplastic oligodendrogliomas are rare diffuse gliomas. Although radiotherapy (RT) combined with procarbazine, lomustine, and vincristine (PCV) has been the historical standard, temozolomide (TMZ) has been increasingly used. OBJECTIVE: To compare the efficacy of RT combined with PCV versus RT combined with TMZ in adult with anaplastic oligodendroglioma. 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. 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 was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS) and progression-free survival (PFS). Risk of bias was assessed with RoB 2 and ROBINS-I. The protocol was registered in PROSPERO (CRD420251012169). No funding was received. RESULTS: Eight studies comprising 2,416 patients were included. 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. In the comparison between RT + PCV and RT + TMZ, 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). Limitations include the small number of randomized trials directly comparing key outcomes, and the fact that most studies predated current molecular diagnostic criteria, with toxicity data often reported in heterogeneous populations. CONCLUSION: In patients with anaplastic oligodendroglioma, RT combined with PCV provides superior survival outcomes compared to radiotherapy combined with TMZ.
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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 | 0.007 | 0.013 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.015 | 0.023 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
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".