CHOD/BVAM Chemotherapy and Whole-Brain Radiotherapy for Newly Diagnosed Primary Central Nervous System Lymphoma

Journal Article · Sat Oct 01 04:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2010.06.002· OSTI ID:21587738

Laack, Nadia N ^[1]; Ballman, Karla V; O'Fallon, Judith Rich; Carrero, Xiomara W ^[2]; Kurtin, Paul J; Scheithauer, Bernd W ^[3]; Brown, Paul D ^[1]; Habermann, Thomas M; Colgan, Joseph P ^[4]; Gilbert, Mark R ^[5]; Hawkins, Roland B ^[6]; Morton, Roscoe F ^[7]; Windschitl, Harry E ^[8]; Fitch, Tom R ^[4]; Pajon, Eduardo R ^[9]

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1. Department of Radiation Oncology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota (United States)
2. Division of Biostatistics, Mayo Clinic and Mayo Foundation, Rochester, Minnesota (United States)
3. Department of Pathology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota (United States)
4. Division of Hematology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota (United States)
5. Department of Neuro-Oncology, The M.D. Anderson Cancer Center, Houston, Texas (United States)
6. Oschner CCOP, New Orleans, Louisiana (United States)
7. Iowa Oncology Research Association CCOP, Des Moines, Iowa (United States)
8. CentraCare Clinic, St. Cloud, Minnesota (United States)
9. Colorado Cancer Research Program, Denver, Colorado (United States)

Purpose: To assess the efficacy and toxicity of chemotherapy consisting of cyclophosphamide, doxorubicin (Adriamycin), vincristine, and dexamethasone (CHOD) plus bis-chloronitrosourea (BCNU), cytosine arabinoside, and methotrexate (BVAM) followed by whole-brain irradiation (WBRT) for patients with primary central nervous system lymphoma (PCNSL). Methods and Materials: Patients 70 years old and younger with newly diagnosed, biopsy-proven PCNSL received one cycle of CHOD followed by two cycles of BVAM. Patients then received WBRT, 30.6 Gy, if a complete response was evoked, or 50.4 Gy if the response was less than complete; both doses were given in 1.8-Gy daily fractions. The primary efficacy endpoint was 1-year survival. Results: Thirty-six patients (19 men, 17 women) enrolled between 1995 and 2000. Median age was 60.5 years (range, 34 to 69 years). Thirty (83%) patients had baseline Eastern Cooperative Oncology Group performance scores of 0 to 1. All 36 patients were eligible for survival and response evaluations. Median time to progression was 12.3 months, and median survival was 18.5 months. The percentages of patients alive at 1, 2, and 3 years were 64%, 36%, and 33%, respectively. The best response was complete response in 10 patients and immediate progression in 7 patients. Ten (28%) patients had at least one grade 3 or higher neurologic toxicity. Conclusions: This regimen did improve the survival of PCNSL patients but also caused substantial toxicity. The improvement in survival is less than that reported with high-dose methotrexate-based therapies.

• OSTI ID: 21587738
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 81; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
ADRENAL HORMONES
ALKYLATING AGENTS
AMINES
ANTI-INFECTIVE AGENTS
ANTIBIOTICS
ANTIMETABOLITES
ANTINEOPLASTIC DRUGS
AZINES
BIOPSY
BODY
BRAIN
CENTRAL NERVOUS SYSTEM
CHEMOTHERAPY
CORTICOSTEROIDS
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DIAGNOSTIC TECHNIQUES
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DOXORUBICIN
DRUGS
ENDOXAN
GLUCOCORTICOIDS
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HORMONES
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IMMUNE SYSTEM DISEASES
IMMUNOSUPPRESSIVE DRUGS
IRRADIATION
KETONES
LYMPHOMAS
MEDICINE
METHOTREXATE
NEOPLASMS
NERVOUS SYSTEM
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANIC OXYGEN COMPOUNDS
ORGANS
PREGNANES
PYRIMIDINES
RADIATION DOSES
RADIOLOGY
RADIOTHERAPY
STEROID HORMONES
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