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Oligodendroglioma

Oligodendrogliomas are a rare type of brain tumour that develops from glial cells called oligodendrocytes. They are more common in adults than in children.

Symptoms of oligodendroglioma depend on where the tumour is in the brain. Common symptoms include headaches and seizures (fits). 

What are oligodendrogliomas?

Oligodendrogliomas develop from glial cells called oligodendrocytes. These cells make a fatty white substance (myelin) that covers the nerves. Myelin helps signals (impulses) to travel along the nerves more quickly. 

Oligodendrogliomas are mostly found in the frontal lobe of the cerebrum. They can also start in the spinal cord, but this is rare. 

Diagram showing the lobes of the brain

Rarely, oligodendrogliomas can spread to other parts of the brain and the spinal cord.

Types of oligodendrogliomas

Oligodendrogliomas are put into groups based on how quickly they are likely to grow. This is called the grade. They can be low grade (slow growing) or high grade (fast growing).

High grade tumours are also called grade 3 or anaplastic oligodendroglioma.

How common it is

Oligodendrogliomas are rare. About 3 out of every 100 brain tumours (3%) diagnosed in England between 2006 and 2010 were oligodendrogliomas.

What tests will I have?

You have tests to diagnose an oligodendroglioma. Your doctor checks the size of the tumour and its location. This helps your doctor plan your treatment. The tests you might have include:

  • MRI scan or CT scan
  • a biopsy
  • blood tests
  • a test of your neurological system (neurological examination)

Treatment

Treatment depends on whether the oligodendroglioma is low grade (slow growing) or high grade (fast growing). It also depends on whether you have changes (mutations) in certain genes.

Treatment for low grade oligodendroglioma

Surgery is usually the first treatment you have. The exact type of surgery you have depends on where the tumour is. A highly specialist doctor (neurosurgeon) removes as much of the tumour as possible.

Oligodendrogliomas tend to grow into the brain tissue surrounding the tumour. This means that they don’t have a clear border between the tumour and the normal brain tissue. Not having a clear border can make it difficult to remove the tumour completely.

Your doctor might monitor you with regular MRI scans. This is called active monitoring. You may have active monitoring if you have a very slow growing oligodendroglioma.  

You might have radiotherapy after surgery. Radiotherapy uses high energy x-rays to destroy cancer cells. You may have radiotherapy after surgery if:

  • you have a gene change called a 1p/19q co-deletion
  • you are over 40 years old
  • doctors can see tumour left behind after surgery

You might have chemotherapy before or after radiotherapy. Chemotherapy uses cytotoxic drugs to destroy cancer cells. You usually have a combination of chemotherapy drugs called PCV. It includes the drugs:

  • procarbazine
  • lomustine (CCNU)
  • vincristine

Treatment for high grade oligodendroglioma

Surgery is the main treatment for high grade oligodendroglioma. A specialist doctor called neurosurgeon removes as much of the tumour as possible. This is called debulking.

It is not usually possible to remove all of the tumour. So your doctor might recommend you have radiotherapy and chemotherapy afterwards.

Radiotherapy uses high energy x-rays to destroy cancer cells. You might have radiotherapy after surgery if you are well overall and able to care for yourself.

Chemotherapy uses cytotoxic drugs to destroy cancer cells. You might have a combination of chemotherapy drugs called PCV before or after radiotherapy. PCV includes the drugs:

  • procarbazine
  • lomustine (CCNU)
  • vincristine

Treatment for oligodendroglioma that comes back

Your treatment depends on what treatment you have already had. You might have a combination of:

  • chemotherapy with lomustine, temozolomide or PCV
  • more surgery
  • more radiotherapy

Follow up

You have regular appointments with your doctor or nurse after treatment finishes. Your doctor examines you at each appointment. They ask how you are feeling, whether you have had any symptoms or side effects, and if you are worried about anything. You might also have MRI scans on some visits.

How often you have checks ups depend on your individual situation.

For a low grade oligodendroglioma, you might have an MRI scan every 6 months, for two years. You then have an MRI scan every year or every 2 years.

For a high grade oligodendroglioma, you might have an MRI scan every 3 to 6 months, for two years. You then have an MRI scan every 6 months or every year.

Coping with oligodendroglioma

Coping with a diagnosis of a brain tumour can be difficult, both practically and emotionally. It can be especially difficult when you have a high grade tumour. Being well informed about the type of tumour you have, and its treatment can make it easier to cope.  

Research and clinical trials

Doctors are always trying to improve the diagnosis and treatment of brain tumours. As part of your treatment, your doctor might ask you to take part in a clinical trial. This might be to test a new treatment or look at different combinations of existing treatments.

Last reviewed: 
30 Oct 2019
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    VT DeVita, TS Lawrence and SA Rosenberg
    Lippincott, Williams and Wilkins, 2015

  • Brain tumours (primary) and brain metastases in adults
    The National Institute for Health and Care Excellence (NICE), July 2018

  • Incidence statistics from Cancer Research UK (Cancer Stats)
    Accessed August 2019

  • IDH-mutant, 1p/19q-codeleted oligodendrogliomas: Clinical features, pathology, and prognostic factors
    Martin van den Bent
    UpToDate, Last accessed February 2019

  • The 2016 World Health Organisation Classification of Tumors of the Central Nervous System: a summary
    DN Louis and others
    Acta Neuropathologica, 2016. Vol 131, Issue 6, Pages 803-820

  • High-grade glioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    R Stupp and others
    Annals of Oncology, 2014. Vol 25, Supplement 3. Pages 93-101

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