Combined-modality therapy for primary central nervous system lymphoma: Long-term data from a Phase II multicenter study (trans-Tasman radiation oncology group)
Combined-modality therapy for primary central nervous system lymphoma: Long-term data from a Phase II multicenter study (trans-Tasman radiation oncology group)
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DOI：
10.1016/j.ijrobp.2005.07.958
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发表时间：
2006-02-01
影响因子：
7
通讯作者：
Trotter, GE
中科院分区：
文献类型：
--
作者：
O'Brien, PC;Roos, DE;Trotter, GE
目的：在多中心环境中，评估原发性中枢神经系统淋巴瘤（PCNSL）患者接受短期高剂量甲氨蝶呤治疗后进行放疗的长期结局。方法和材料：46例患者进入11期方案，包括甲氨蝶呤（1 g/m2，第1天和第8天），然后进行全脑放疗（45- 50. 4戈伊）。中位随访时间为7年，最短随访时间为5年。结果：5年生存率估计为37%（+/-14%，95%置信区间[CI]），无进展生存率为36%（+/-15%，95% CI），中位生存期为36个月。在最初的46名患者中，有10名存活，均没有疾病复发的证据。共有11例患者发生神经毒性，5年时的精算风险为30%（+/-18%，95% CI），但持续增加。对于年龄>60岁的患者，7年时神经毒性的风险为58%（+/-30%，95%CI）。结论：基于大剂量甲氨蝶呤的联合治疗可改善PCNSL的生存结局。对于年龄>60岁的患者，神经毒性的风险是不可接受的，尽管年龄>60岁的患者的生存结局高于许多其他系列。(C)2006年爱思唯尔公司
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 11 protocol consisting of methotrexate (1 g/m(2) on Days I 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. (C) 2006 Elsevier Inc.