{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T08:38:54Z","timestamp":1789115934600,"version":"build-2803163510"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T00:00:00Z","timestamp":1612742400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T00:00:00Z","timestamp":1612742400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cancer"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Following optimal local therapy, adjuvant Procarbazine, Lomustine and Vincristine (PCV) improves overall survival (OS) in low-grade glioma (LGG). However, 1 year of PCV is associated with significant toxicities. In the pivotal RTOG 9802 randomised control trial, approximately half of the patients discontinued treatment after 6 months. As patients on clinical trials may be fitter, we aimed to further explore the tolerability of PCV chemotherapy in routine clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective study between 2014 and 2018 at a National Neuro-Oncology centre. Patients who had received PCV during this time period were included. The primary objective was to assess tolerability of treatment. Secondary objectives included evaluation of treatment delays, dose modifications and toxicities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 41 patients were included, 24 (58%) were male and 21 (51%) aged \u226540\u2009years. 38 (93%) underwent surgical resection and all patients received adjuvant radiotherapy prior to chemotherapy. The median number of cycles completed was 3,2,4 for procarbazine, lomustine and vincristine respectively. Only 4 (10%) completed all 6 cycles of PCV without dose modifications. There was a universal decline in dose intensity as cycles of chemotherapy progressed. Dose intensity for cycle 1 versus cycle 6 respectively: procarbazine (98% versus 46%), lomustine (94% versus 48%) and vincristine (93% versus 50%). Haematological toxicities were common. Six (14%) patients experienced Grade III-IV thrombocytopaenia and 13 (31%) experienced Grade III-IV neutropaenia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Toxicities are frequently observed with the PCV regimen in clinical practice. It might be preferable to adjust doses from the start of chemotherapy to improve tolerability or consider alternative chemotherapy, particularly in older patients with LGG.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12885-021-07809-5","type":"journal-article","created":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T17:48:23Z","timestamp":1612806503000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["One year of procarbazine lomustine and vincristine is poorly tolerated in low grade glioma: a real world experience in a national neuro-oncology centre"],"prefix":"10.1186","volume":"21","author":[{"given":"Rachel J.","family":"Keogh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Razia","family":"Aslam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maeve A.","family":"Hennessy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zac","family":"Coyne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan T.","family":"Hennessy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar S.","family":"Breathnach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liam","family":"Grogan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6055-5273","authenticated-orcid":false,"given":"Patrick G.","family":"Morris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,8]]},"reference":[{"issue":"4","key":"7809_CR1","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1093\/nop\/npy034","volume":"6","author":"TJ Brown","year":"2018","unstructured":"Brown TJ, Bota DA, van Den Bent MJ, Brown PD, Maher E, Aregawi D, et al. Management of low-grade glioma: a systematic review and meta-analysis. Neuro Oncol Pract. 2018;6(4):249\u201358.","journal-title":"Neuro Oncol Pract"},{"issue":"6","key":"7809_CR2","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1007\/s00401-016-1545-1","volume":"131","author":"DN Louis","year":"2016","unstructured":"Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, et al. The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol. 2016;131(6):803\u201320.","journal-title":"Acta Neuropathol"},{"issue":"Suppl 4","key":"7809_CR3","doi-asserted-by":"publisher","first-page":"iv1","DOI":"10.1093\/neuonc\/nov189","volume":"17","author":"QT Ostrom","year":"2015","unstructured":"Ostrom QT, Gittleman H, Fulop J, Liu M, Blanda R, Kromer C, et al. CBTRUS Statistical Report: Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2008\u20132012. Neuro-Oncology. 2015;17(Suppl 4):iv1\u2013iv62.","journal-title":"Neuro-Oncology"},{"issue":"14","key":"7809_CR4","doi-asserted-by":"publisher","first-page":"1344","DOI":"10.1056\/NEJMoa1500925","volume":"374","author":"JC Buckner","year":"2016","unstructured":"Buckner JC, Shaw EG, Pugh SL, Chakravarti A, Gilbert MR, Barger GR, et al. Radiation plus Procarbazine, CCNU, and vincristine in low-grade Glioma. N Engl J Med. 2016;374(14):1344\u201355.","journal-title":"N Engl J Med"},{"issue":"5","key":"7809_CR5","doi-asserted-by":"publisher","first-page":"835","DOI":"10.3171\/JNS\/2008\/109\/11\/0835","volume":"109","author":"EG Shaw","year":"2008","unstructured":"Shaw EG, Berkey B, Coons SW, Bullard D, Brachman D, Buckner JC, et al. Recurrence following neurosurgeon-determined gross-total resection of adult supratentorial low-grade glioma: results of a prospective clinical trial. J Neurosurg. 2008;109(5):835\u201341.","journal-title":"J Neurosurg"},{"issue":"8","key":"7809_CR6","doi-asserted-by":"publisher","first-page":"2076","DOI":"10.1200\/JCO.2002.08.121","volume":"20","author":"F Pignatti","year":"2002","unstructured":"Pignatti F, van den Bent M, Curran D, Debruyne C, Sylvester R, Therasse P, et al. Prognostic factors for survival in adult patients with cerebral low-grade glioma. J Clin Oncol. 2002;20(8):2076\u201384.","journal-title":"J Clin Oncol"},{"issue":"3","key":"7809_CR7","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1200\/JCO.2012.43.2674","volume":"31","author":"G Cairncross","year":"2013","unstructured":"Cairncross G, Wang M, Shaw E, Jenkins R, Brachman D, Buckner J, et al. Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma: long-term results of RTOG 9402. J Clin Oncol. 2013;31(3):337\u201343.","journal-title":"J Clin Oncol"},{"issue":"3","key":"7809_CR8","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1200\/JCO.2012.43.2229","volume":"31","author":"MJ van den Bent","year":"2013","unstructured":"van den Bent MJ, Brandes AA, Taphoorn MJ, Kros JM, Kouwenhoven MC, Delattre JY, et al. Adjuvant procarbazine, lomustine, and vincristine chemotherapy in newly diagnosed anaplastic oligodendroglioma: long-term follow-up of EORTC brain tumor group study 26951. J Clin Oncol. 2013;31(3):344\u201350.","journal-title":"J Clin Oncol"},{"issue":"25","key":"7809_CR9","doi-asserted-by":"publisher","first-page":"3065","DOI":"10.1200\/JCO.2011.35.8598","volume":"30","author":"EG Shaw","year":"2012","unstructured":"Shaw EG, Wang M, Coons SW, Brachman DG, Buckner JC, Stelzer KJ, et al. Randomized trial of radiation therapy plus procarbazine, lomustine, and vincristine chemotherapy for supratentorial adult low-grade glioma: initial results of RTOG 9802. J Clin Oncol. 2012;30(25):3065\u201370.","journal-title":"J Clin Oncol"},{"key":"7809_CR10","volume-title":"Common Terminology Criteria for Adverse Events (CTCAE)","author":"National Institutes of Health NCI, U.S.Department of Health and Human Services","year":"2009","unstructured":"National Institutes of Health NCI, U.S.Department of Health and Human Services. Common Terminology Criteria for Adverse Events (CTCAE). 2009;Version 4.0."},{"issue":"18","key":"7809_CR11","doi-asserted-by":"publisher","first-page":"2715","DOI":"10.1200\/JCO.2005.04.6078","volume":"24","author":"MJ van den Bent","year":"2006","unstructured":"van den Bent MJ, Carpentier AF, Brandes AA, Sanson M, Taphoorn MJB, Bernsen HJJA, et al. Adjuvant Procarbazine, Lomustine, and vincristine improves progression-free survival but not overall survival in newly diagnosed anaplastic Oligodendrogliomas and Oligoastrocytomas: a randomized European Organisation for Research and Treatment of Cancer phase III trial. J Clin Oncol. 2006;24(18):2715\u201322.","journal-title":"J Clin Oncol"},{"issue":"18","key":"7809_CR12","doi-asserted-by":"publisher","first-page":"2707","DOI":"10.1200\/JCO.2005.04.3414","volume":"24","author":"G Cairncross","year":"2006","unstructured":"Cairncross G, Berkey B, Shaw E, Jenkins R, Scheithauer B, Brachman D, et al. Phase III trial of chemotherapy plus radiotherapy compared with radiotherapy alone for pure and mixed anaplastic Oligodendroglioma: intergroup radiation therapy oncology group trial 9402. J Clin Oncol. 2006;24(18):2707\u201314.","journal-title":"J Clin Oncol"},{"issue":"11","key":"7809_CR13","first-page":"1529","volume":"18","author":"W Wick","year":"2016","unstructured":"Wick W, Roth P, Hartmann C, Hau P, Nakamura M, Stockhammer F, et al. Long-term analysis of the NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with PCV or temozolomide. Neuro Oncology. 2016;18(11):1529\u201337.","journal-title":"Neuro Oncology"},{"issue":"6167","key":"7809_CR14","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1126\/science.1239947","volume":"343","author":"BE Johnson","year":"2014","unstructured":"Johnson BE, Mazor T, Hong C, Barnes M, Aihara K, McLean CY, et al. Mutational analysis reveals the origin and therapy-driven evolution of recurrent glioma. Science. 2014;343(6167):189\u201393.","journal-title":"Science."},{"key":"7809_CR15","doi-asserted-by":"crossref","unstructured":"Jaeckle K, Vogelbaum M, Ballman K, Anderson SK, Giannini C, Aldape K, et al. CODEL (Alliance-N0577; EORTC-26081\/22086; NRG-1071; NCIC-CEC-2): Phase III Randomized Study of RT vs. RT+TMZ vs. TMZ for Newly Diagnosed 1p\/19q-Codeleted Anaplastic Oligodendroglial Tumors. Analysis of Patients Treated on the Original Protocol Design (PL02.005). Neurology. 2016;86(16 Supplement) PL02.005.","DOI":"10.1093\/neuonc\/nov206.16"},{"key":"7809_CR16","unstructured":"Author N. Health Research consent declaration committee: retrospective chart reviews [updated April 30th 2019]. Available from: https:\/\/hrcdc.ie\/retrospective-chart-reviews\/."}],"container-title":["BMC Cancer"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12885-021-07809-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12885-021-07809-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12885-021-07809-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T17:51:59Z","timestamp":1612806719000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmccancer.biomedcentral.com\/articles\/10.1186\/s12885-021-07809-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,8]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["7809"],"URL":"https:\/\/doi.org\/10.1186\/s12885-021-07809-5","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-115879\/v1","asserted-by":"object"}]},"ISSN":["1471-2407"],"issn-type":[{"value":"1471-2407","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,8]]},"assertion":[{"value":"24 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 January 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 February 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study was approved by the Audit office at Beaumont Hospital, Dublin, Ireland. This approval included all administrative permissions necessary to access and use the study administrative data. As a retrospective study, no informed consent was obtained. This is in compliance with National Guidelines as indicated by the Health Research Consent Declaration Committee on Retrospective Chart Review (Updated August 30th, 2019) [\n                      \n                      ].","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"PGM received travel support from Roche, Novartis, Amgen. PGM received honoraria from Astellas, Novartis, Pfizer, Teva, Nordic, Bristol Meyers Squibb, Astra Zeneca, Genomic health, Roche. PGM has a consultancy\/advisory role with Novartis. PGM has had a speaker role with Teva. PGM received research funding from Teva and Genomic Health however no funding was obtained for this study. All other authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"140"}}