PURPOSE: To assess, in a multicenter setting, the long-term outcomes of a brief course of high-dose methotrexate followed by radiotherapy for patients with primary central nervous system lymphoma (PCNSL). METHODS AND MATERIALS: Forty-six patients were entered in a Phase II protocol consisting of methotrexate (1 g/m(2) on Days 1 and 8), followed by whole-brain irradiation (45-50.4 Gy). The median follow-up time was 7 years, with a minimum follow-up of 5 years. RESULTS: The 5-year survival estimate was 37% (+/-14%, 95% confidence interval [CI]), with progression-free survival being 36% (+/-15%, 95% CI), and median survival 36 months. Of the original 46 patients, 10 were alive, all without evidence of disease recurrence. A total of 11 patients have developed neurotoxicity, with the actuarial risk being 30% (+/-18%, 95% CI) at 5 years but continuing to increase. For patients aged>60 years the risk of neurotoxicity at 7 years was 58% (+/-30%, 95% CI). CONCLUSION: Combined-modality therapy, based on high-dose methotrexate, results in improved survival outcomes in PCNSL. The risk of neurotoxicity for patients aged>60 years is unacceptable with this regimen, although survival outcomes for patients aged>60 years were higher than in many other series.
PURPOSE: To assess, in a multicenter setting, the long-term outcomes of a brief course of high-dose methotrexate followed by radiotherapy for patients with primary central nervous system lymphoma (PCNSL). METHODS AND MATERIALS: Forty-six patients were entered in a Phase II protocol consisting of methotrexate (1 g/m(2) on Days 1 and 8), followed by whole-brain irradiation (45-50.4 Gy). The median follow-up time was 7 years, with a minimum follow-up of 5 years. RESULTS: The 5-year survival estimate was 37% (+/-14%, 95% confidence interval [CI]), with progression-free survival being 36% (+/-15%, 95% CI), and median survival 36 months. Of the original 46 patients, 10 were alive, all without evidence of disease recurrence. A total of 11 patients have developed neurotoxicity, with the actuarial risk being 30% (+/-18%, 95% CI) at 5 years but continuing to increase. For patients aged>60 years the risk of neurotoxicity at 7 years was 58% (+/-30%, 95% CI). CONCLUSION: Combined-modality therapy, based on high-dose methotrexate, results in improved survival outcomes in PCNSL. The risk of neurotoxicity for patients aged>60 years is unacceptable with this regimen, although survival outcomes for patients aged>60 years were higher than in many other series.
Authors: Hyeon Kang Koh; Il Han Kim; Tae Min Kim; Do Hoon Lim; Dongryul Oh; Jae Ho Cho; Woo-Chul Kim; Jin Hee Kim; Woong-Ki Chung; Bae-Kwon Jeong; Ki Mun Kang; Semie Hong; Chang-Ok Suh; In Ah Kim Journal: J Neurooncol Date: 2017-09-22 Impact factor: 4.130
Authors: Hendrik Pels; Annika Juergens; Axel Glasmacher; Holger Schulz; Andreas Engert; Michael Linnebank; Gabriele Schackert; Heinz Reichmann; Frank Kroschinsky; Marlies Vogt-Schaden; Gerlinde Egerer; Udo Bode; Carlo Schaller; Monika Lamprecht; Peter Hau; Martina Deckert; Rolf Fimmers; Christopher Bangard; Ingo G H Schmidt-Wolf; Uwe Schlegel Journal: J Neurooncol Date: 2008-10-18 Impact factor: 4.130
Authors: Jay-Jiguang Zhu; Elizabeth R Gerstner; David A Engler; Maciej M Mrugala; Whitney Nugent; Kristin Nierenberg; Fred H Hochberg; Rebecca A Betensky; Tracy T Batchelor Journal: Neuro Oncol Date: 2008-08-29 Impact factor: 12.300