TY - JOUR
T1 - A multicenter study of treatment of primary CNS lymphoma
AU - Ferreri, A. J M
AU - Reni, M.
AU - Pasini, F.
AU - Calderoni, A.
AU - Tirelli, U.
AU - Pivnik, A.
AU - Aondio, G. M.
AU - Ferrarese, F.
AU - Gomez, H.
AU - Ponzoni, M.
AU - Borisch, B.
AU - Berger, F.
AU - Chassagne, C.
AU - Iuzzolino, P.
AU - Carbone, A.
AU - Weis, J.
AU - Pedrinis, E.
AU - Motta, T.
AU - Jouvet, A.
AU - Barbui, T.
AU - Cavalli, F.
AU - Blay, J. Y.
PY - 2002/5/28
Y1 - 2002/5/28
N2 - Objective: To characterize the therapeutic variables correlated to outcome in 370 patients with primary CNS lymphoma. Methods: Planned treatment was radiotherapy (RT) in 98 patients, chemotherapy (CHT) in 32, RT followed by CHT in 36, and CHT followed by RT in 197 patients. High-dose methotrexate (HD-MTX; 1 to 8 g/m2) was used in 169 patients and intrathecal CHT in 109. Results: One hundred sixteen patients are alive (median follow-up 24 months), with a 2-year overall survival of 37%. Patients treated with CHT followed by RT had improved survival with respect to patients treated with RT alone. Patients receiving HD-MTX-based primary CHT survived longer than those treated with other drugs. HD-MTX associated with other cytostatics, in particular HD-cytarabine, produced better results than HD-MTX alone. No correlation between MTX dose and survival was found. In patients receiving HD-MTX, consolidation RT or intrathecal CHT did not improve survival. Age, performance status, lactate dehydrogenase serum level, CSF protein level, site of disease, and use of HD-MTX were all predictors of survival. Conclusions: Combination CHT-RT is superior to RT alone. Patients treated with primary CHT containing HD-MTX exhibited improved survival. In these patients, the addition of HD-cytarabine was associated with a better survival, whereas intrathecal CHT was not correlated to outcome. RT may be unnecessary in patients achieving complete remission after receiving HD-MTX-based primary CHT.
AB - Objective: To characterize the therapeutic variables correlated to outcome in 370 patients with primary CNS lymphoma. Methods: Planned treatment was radiotherapy (RT) in 98 patients, chemotherapy (CHT) in 32, RT followed by CHT in 36, and CHT followed by RT in 197 patients. High-dose methotrexate (HD-MTX; 1 to 8 g/m2) was used in 169 patients and intrathecal CHT in 109. Results: One hundred sixteen patients are alive (median follow-up 24 months), with a 2-year overall survival of 37%. Patients treated with CHT followed by RT had improved survival with respect to patients treated with RT alone. Patients receiving HD-MTX-based primary CHT survived longer than those treated with other drugs. HD-MTX associated with other cytostatics, in particular HD-cytarabine, produced better results than HD-MTX alone. No correlation between MTX dose and survival was found. In patients receiving HD-MTX, consolidation RT or intrathecal CHT did not improve survival. Age, performance status, lactate dehydrogenase serum level, CSF protein level, site of disease, and use of HD-MTX were all predictors of survival. Conclusions: Combination CHT-RT is superior to RT alone. Patients treated with primary CHT containing HD-MTX exhibited improved survival. In these patients, the addition of HD-cytarabine was associated with a better survival, whereas intrathecal CHT was not correlated to outcome. RT may be unnecessary in patients achieving complete remission after receiving HD-MTX-based primary CHT.
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M3 - Article
C2 - 12034789
AN - SCOPUS:0037188399
SN - 0028-3878
VL - 58
SP - 1513
EP - 1520
JO - Neurology
JF - Neurology
IS - 10
ER -