There are several kinds of chemotherapy that can be part of the treatment regimen for Oligo. The good news is that most of them are taken in pill form and are tolerated pretty well by most people. The bad news is that chemotherapy is only somewhat effective. There has been a lot written about how Oligos or more receptive to chemo, but that is not the same as being truly effective.
It is pretty much unheard of for chemotherapy to make your tumor disappear. In some cases, the tumor may shrink but even that is not all that common. Whether you are taking temodar post surgery or doing PCV post radiation, the goal of the chemo is to put the cancer on hold. When successful, this can last a year or 10+ depending on the patient and situation.
The common forms of chemo used on Oligo include:
Temodar/temozolomide—This was approved for use in the 1990’s, which makes it the newest drug used for our disease. It is used solo, with radiation, and post radiation depending on the situation and the doctor. Perhaps the most common dosing in 4 days on 24 off, but it is sometime used daily with a low dose or concurrent with radiation.
CCNU (Lomustine)—An older form of chemotherapy that works in a different way that temodar. It is more damaging to healthy tissue and so it can only be used once (6 cycles). Taken as a single dose, typically monthly for up to 6 months.
PCV—Procarbozine, CCNU, Vincristine. This combination is used almost exclusively following radiation therapy. Procarbozine is similar to temodar (and temodar can be used instead). Vincristine is controversial based on the fact that it doesn’t cross the blood-brain-barrier and it is poorly tolerated by many. However, this is what most neuro oncologists recommend based on the fact that the combination of radiation and PCV is the only treatment that has meaningful positive results from a clinical trial. Vincristine is administered by IV and many patients drop it after a few cycles.
Important Note: Chemotherapy can often cause infertility, so saving sperm or eggs is something to consider depending on your age and circumstances.