In Regard to Lassman et al

In Regard to Lassman et al. Neuro-Oncol. 2011;13:649–659. The treatment of patients with anaplastic oligodendroglial tumors remains controversial. Initial treatment with radiation therapy associated or not with concomitant and/or sequential procarbazine, lomustine, and vincristine (PCV) chemotherapy is historically the most frequent approach to treat this disease.1 Radiation therapy has been reported for the treatment of the oligodendrogliomas since the 1960s2 and has been established as an effective treatment for increasing these patients’ probability of surviving 5 years after subtotal tumor resection since the 1980s.3 From the RTOG 94024 and EORTC 269515 well-designed phase III trials, we have the information that patients presenting with anaplastic oligodendroglial tumors with 1p19q codeletion have better prognosis and response to treatment, either radiation or chemotherapy. The early addition of chemotherapy in these trials improved the progression-free survival but not overall survival. In addition, the neurologic function was not assessed; thus, the real impact of this approach was not fully evaluated. The strength of this article is based on an impressive number of patients, with the retrospective analysis of >1000 patients with anaplastic olidendroglial tumors. However, the 3 initial treatment groups (chemotherapy, radio-chemotherapy, and radiation therapy) were too heterogeneous. Most received combined radio-chemotherapy as the first treatment, demonstrating the preference of the clinicians for this approach. Seventy-three percent of the patients who received chemotherapy as the first treatment and had a known 1p19q status had a codeleted status, compared with 85% in the chemotherapy and radiation therapy arm, compared with