Combined-modality therapy for primary central nervous system lymphoma: Long-term data from a Phase II multicenter study (Trans-Tasman Radiation Oncology Group)
- Radiation Oncology Department, Newcastle Mater Hospital, New South Wales (Australia)
- Radiation Oncology Department, Royal Adelaide Hospital, South Australia (Australia)
- Royal Brisbane Hospital, Queensland (Australia)
- Peter MacCallum Cancer Institute, Victoria (Australia)
- Centre for Clinical Outcomes Research and Education (CCORE), Liverpool Hospital, New South Wales (Australia)
- Southern Zone Radiation Oncology, Mater Centre, Queensland (Australia)
- East Coast Cancer Centre, Queensland (Australia)
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{sup 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.
- OSTI ID:
- 20793298
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 64, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2005.07.958; PII: S0360-3016(05)02145-0; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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