PURPOSE: The aim of this study was to evaluate the efficacy, toxicity, and survival of whole-brain radiotherapy-treated (WBRT) and high-dose methylprednisolone (HDMP)-treated in elderly patients with primary central nervous system lymphoma (PCNSL). METHODS AND MATERIALS: Patients with PCNSL who were 70 years and older received 1 g of methylprednisolone daily for 5 days, 30 days after WBRT. Patients then received 1 g of methylprednisolone every 28 days until progression. The primary endpoint was overall survival (OS) at 6 months. Results were compared with those in patients on the previous North Central Cancer Treatment Group (NCCTG) trial who received pre-WBRT cytoxan, adriamycin, vincristine, prednisone (CHOP) and high-dose cytarabine (CHOP-WBRT). A planned interim analysis was performed. The current regimen would be considered inactive if survival was not improved from patients treated with CHOP-WBRT. RESULTS: Nineteen patients were accrued between 1998 and 2003. Median age was 76 years. Interim analysis revealed a 6-month survival of 33%, resulting in closure of the trial. Toxicity, OS, and event-free survival (EFS) were similar to those in patients more than 70 years of age who received CHOP-WBRT. The subgroup of patients who received HDMP had longer OS (12.1 vs. 7.0 months, p = 0.76) and EFS (11.7 vs. 4.0 months, p = 0.04) compared with the CHOP-WBRT patients alive 60 days after the start of treatment. CONCLUSIONS: Patients on-study long enough to receive HDMP had prolongation of OS and EFS compared to patients receiving CHOP-WBRT. Although the numbers of patients are too small for statistical conclusions, the HDMP regimen deserves further study.
PURPOSE: The aim of this study was to evaluate the efficacy, toxicity, and survival of whole-brain radiotherapy-treated (WBRT) and high-dose methylprednisolone (HDMP)-treated in elderly patients with primary central nervous system lymphoma (PCNSL). METHODS AND MATERIALS: Patients with PCNSL who were 70 years and older received 1 g of methylprednisolone daily for 5 days, 30 days after WBRT. Patients then received 1 g of methylprednisolone every 28 days until progression. The primary endpoint was overall survival (OS) at 6 months. Results were compared with those in patients on the previous North Central Cancer Treatment Group (NCCTG) trial who received pre-WBRT cytoxan, adriamycin, vincristine, prednisone (CHOP) and high-dose cytarabine (CHOP-WBRT). A planned interim analysis was performed. The current regimen would be considered inactive if survival was not improved from patients treated with CHOP-WBRT. RESULTS: Nineteen patients were accrued between 1998 and 2003. Median age was 76 years. Interim analysis revealed a 6-month survival of 33%, resulting in closure of the trial. Toxicity, OS, and event-free survival (EFS) were similar to those in patients more than 70 years of age who received CHOP-WBRT. The subgroup of patients who received HDMP had longer OS (12.1 vs. 7.0 months, p = 0.76) and EFS (11.7 vs. 4.0 months, p = 0.04) compared with the CHOP-WBRT patients alive 60 days after the start of treatment. CONCLUSIONS:Patients on-study long enough to receive HDMP had prolongation of OS and EFS compared to patients receiving CHOP-WBRT. Although the numbers of patients are too small for statistical conclusions, the HDMP regimen deserves further study.
Authors: E Schorb; C P Fox; K Fritsch; L Isbell; A Neubauer; A Tzalavras; R Witherall; S Choquet; O Kuittinen; D De-Silva; K Cwynarski; C Houillier; K Hoang-Xuan; V Touitou; N Cassoux; J-P Marolleau; J Tamburini; R Houot; V Delwail; G Illerhaus; C Soussain; B Kasenda Journal: Bone Marrow Transplant Date: 2017-04-24 Impact factor: 5.483
Authors: Benjamin Kasenda; Jay Loeffler; Gerald Illerhaus; Andrés J M Ferreri; James Rubenstein; Tracy T Batchelor Journal: Blood Date: 2016-05-13 Impact factor: 22.113
Authors: B Kasenda; A J M Ferreri; E Marturano; D Forst; J Bromberg; H Ghesquieres; C Ferlay; J Y Blay; K Hoang-Xuan; E J Pulczynski; A Fosså; Y Okoshi; S Chiba; K Fritsch; A Omuro; B P O'Neill; O Bairey; S Schandelmaier; V Gloy; N Bhatnagar; S Haug; S Rahner; T T Batchelor; G Illerhaus; M Briel Journal: Ann Oncol Date: 2015-02-20 Impact factor: 32.976
Authors: Nadia N Laack; Brian Patrick O'Neill; Karla V Ballman; Judith Rich O'Fallon; Xiomara W Carrero; Paul J Kurtin; Bernd W Scheithauer; Paul D Brown; Thomas M Habermann; Joseph P Colgan; Mark R Gilbert; Roland B Hawkins; Roscoe F Morton; Harry E Windschitl; Tom R Fitch; Eduardo R Pajon Journal: Int J Radiat Oncol Biol Phys Date: 2010-08-26 Impact factor: 7.038
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