Combined-modality therapy for primary central nervous system lymphoma: Long-term data from a Phase II multicenter study (trans-Tasman radiation oncology group)

O'Brien, Peter C., Roos, Daniel E., Pratt, Gary, Liew, K.-H., Barton, Michael B., Poulsen, Michael G., Olver, Ian N. and Trotter, Grant E. (2006) Combined-modality therapy for primary central nervous system lymphoma: Long-term data from a Phase II multicenter study (trans-Tasman radiation oncology group). International Journal of Radiation: Oncology - Biology - Physics, 64 2: 408-413. doi:10.1016/j.ijrobp.2005.07.958


Author O'Brien, Peter C.
Roos, Daniel E.
Pratt, Gary
Liew, K.-H.
Barton, Michael B.
Poulsen, Michael G.
Olver, Ian N.
Trotter, Grant E.
Title Combined-modality therapy for primary central nervous system lymphoma: Long-term data from a Phase II multicenter study (trans-Tasman radiation oncology group)
Journal name International Journal of Radiation: Oncology - Biology - Physics   Check publisher's open access policy
ISSN 0360-3016
1879-355X
Publication date 2006-02-01
Year available 2005
Sub-type Article (original research)
DOI 10.1016/j.ijrobp.2005.07.958
Volume 64
Issue 2
Start page 408
End page 413
Total pages 6
Place of publication Philadelphia, PA, United States
Publisher Elsevier
Language eng
Formatted abstract
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/m2 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.
Keyword Lymphoma
Central nervous system
Chemotherapy
Radiotherapy
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ
Additional Notes Available online 28 September 2005

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Tue, 23 Nov 2010, 14:46:48 EST