Evidence map›Paper›PMID 42159820›Full record

ArticleJournal of neuro-oncology2026

Treatment patterns and outcomes in high-risk WHO grade 2 diffuse glioma: a multicentre retrospective cohort study.

Jason L Jia, Bader Alshamsan, Cristina Andronic, Francesco Fazzari, Hely Shah, Jennifer Leigh, Aimee Chan, Mikayla Machado, Mary Jane Lim Fat, Kathie Baer and 7 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Jason L Jia *Department of Medicine, The Ottawa Hospital Cancer Centre, Ottawa, ON, Canada.
Bader Alshamsan *Department of Medicine, College of Medicine, Qassim University, Buraydah, Saudi Arabia.
Cristina AndronicDepartment of Medicine, The Ottawa Hospital Cancer Centre, Ottawa, ON, Canada.
Francesco FazzariDepartment of Oncology, McMaster University, Hamilton, ON, Canada.
Hely ShahDepartment of Medicine, The Ottawa Hospital Cancer Centre, Ottawa, ON, Canada.
Jennifer LeighDivision of Medical Oncology and Hematology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Aimee ChanDivision of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Mikayla MachadoTemerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Mary Jane Lim FatDivision of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Kathie BaerLondon Health Sciences Centre, London, ON, Canada.
Maria MacDonaldDepartment of Oncology and Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON, Canada.
Xin WangTemerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Warren MasonDivision of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Manik ChahalDivision of Medical Oncology, Vancouver, BC, Canada.
Marya HussainDivision of Medical Oncology, Department of Oncology, University of Calgary, Calgary, AB, Canada.
Gloria Roldan UrgoitiDivision of Medical Oncology, Department of Oncology, University of Calgary, Calgary, AB, Canada.
Terry L NgCancer Research Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada. teng@toh.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe optimal adjuvant alkylating chemotherapy regimen for high-risk WHO grade 2 glioma in the molecular era remains uncertain. We evaluated real-world treatment patterns, toxicity, and outcomes following radiotherapy with adjuvant temozolomide (TMZ) or procarbazine, lomustine, and vincristine (PCV) in a multicentre Canadian cohort.

methodsPROTECT is a retrospective multicentre cohort study including adults with clinically defined high-risk WHO grade 2 diffuse glioma treated with radiotherapy and adjuvant alkylating chemotherapy. Clinical, molecular, treatment delivery, toxicity, surveillance, and survival data were collected. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method and compared using the log-rank test and Cox regression.

resultsA total of 116 patients were included, with a median follow-up of 71 months. Isocitrate dehydrogenase (IDH) mutation was present in 84.6% of evaluable cases, and 1p/19q codeletion in 56.6% of tested tumours. Median OS was not reached, with estimated 3- and 5-year OS rates of 97.3% and 94.1%, respectively. Median PFS was 8.4 years, with 3- and 5-year PFS rates of 83.6% and 77.9%, respectively. In multivariable analysis, IDH status was the only independent predictor of PFS (HR = 3.54, 95% CI 1.12-11.15; p = 0.03). Among patients with IDH-mutant tumours, PFS did not differ significantly between TMZ and PCV, including in analyses stratified by 1p/19q status. PCV was associated with higher rates of dose modification, treatment delays, and hematologic toxicity.

conclusionIn high-risk WHO grade 2 glioma, outcomes were favorable with radiotherapy and adjuvant alkylating chemotherapies, with greater toxicity associated with PCV compared to TMZ. IDH mutational status emerged as the dominant prognostic factor. Prospective, molecularly stratified trials are necessary to characterize comparative effectiveness of regimens.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBrain NeoplasmsGliomaAdultAgedFemaleFollow-Up StudiesHumansLomustineMaleMiddle AgedNeoplasm GradingProcarbazinePrognosisRetrospective StudiesTemozolomideLomustineProcarbazineTemozolomideVincristine1p/19q codeletionIDH mutationPCV chemotherapyProgression-free survivalTemozolomideWHO grade 2 glioma

Identifiers

PMID42159820

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.