Combination chemotherapy and radiotherapy for primary central nervous system lymphoma: Radiation Therapy Oncology Group study 93-10
Combination chemotherapy and radiotherapy for primary central nervous system lymphoma: Radiation Therapy Oncology Group study 93-10
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DOI：
10.1200/jco.2002.11.013
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发表时间：
2002-12-15
影响因子：
45.3
通讯作者：
Schultz, CJ
中科院分区：
文献类型：
--
作者：
DeAngelis, LM;Seiferheld, W;Schultz, CJ
目的：原发性中枢神经系统淋巴瘤（PCNSL）是一种侵袭性原发性脑肿瘤。单独的颅脑照射很少能实现长期疾病控制或延长生存。我们前瞻性地研究了联合化疗加颅脑放疗在新诊断的 PCNSL 患者中的应用。 患者和方法：我们招募了 102 名新诊断的、免疫功能正常的 PCNSL 患者； 98 是可评估的。患者首先接受五个周期的甲氨蝶呤 2.5 g/m(2)、长春新碱、丙卡巴肼和心室内甲氨蝶呤 (12 mg)。全脑放疗 (RT) 的总剂量为 45 Gy，所有患者在放疗后均接受高剂量阿糖胞苷。结果：58% 的可测量疾病患者对放疗前化疗有完全缓解，36% 的患者有部分 (>50%) 缓解，缓解率为 94%。中位无进展生存期为 24.0 个月，总生存期为 36.9 个月。年龄是一个重要的预后因素； 60 岁以下患者的中位生存期为 50.4 个月，60 岁或以上患者的中位生存期仅为 21.8 个月（P
Purpose: Primary CNS lymphoma (PCNSL) is an aggressive primary brain tumor. Cranial irradiation alone rarely results in long-term disease control or prolonged survival. We prospectively studied the use of combination chemotherapy plus cranial irradiation in newly diagnosed patients with PCNSL.Patients and Methods: We enrolled 102 newly diagnosed, immunocompetent patients with PCNSL; 98 were assessable. Patients first received five cycles of methotrexate 2.5 g/m(2), vincristine, procarbazine, and intraventricular methotrexate (12 mg). Whole-brain radiotherapy (RT) was administered to a total dose of 45 Gy and all patients received high-dose cytarabine after RT.Results: Fifty-eight percent of patients with measurable disease had a complete response to preirradiation chemotherapy and 36% had a partial (>50%) response, for a 94% response rate. Median progression-free survival was 24.0 months and overall survival was 36.9 months. Age was an important prognostic factor; median survival was 50.4 months in patients younger than 60 and only 21.8 months in those aged 60 or older (P