[High-dose methotrexate followed by whole-brain irradiation for primary central nervous system lymphoma patients--a retrospective study in a single institute].

Abstract

This study analyzed retrospectively the clinical efficacy of combined therapy consisting of high-dose methotrexate (MTX), administered at a dose of 4 g/m2 every 2 weeks (maximum of 4 courses), followed by whole-brain irradiation for newly diagnosed primary central nervous system lymphoma (PCNSL) patients. Fifteen patients (median age: 59 years old; range: 26-79) were diagnosed by histological examinations or imaging techniques in our hospital. Of 15 patients, 12 (6: complete response; 6: partial response) achieved objective response, and the response rate was 80% (95% CI, 51.9-95.7%). The median follow-up time was 20 (range: 3-81) months, and the 3-year survival rate was 76%. The overall survival time was 71 months (95% CI, 23. 7-118.3 months), and the progression free survival was 15 months (95% CI, 0-43.8 months). The major toxicity (grade>or=3) of high-dose MTX included cytopenia (20%), acute respiratory distress syndrome (6.7%), and liver damage (6.7%). No patient evidenced complicated leukoencephalopathy in the follow-up time. The combined therapy of high-dose MTX followed by whole-brain irradiation showed a substantial antitumor efficacy in PCNSL patients. Prospective studies are required to determine the suitable treatment schedule for MTX and irradiation.

• Authors: Noriko Usui, Nobuaki Dobashi, Shingo Yano, Yuichi Yahagi, Yutaka Takei, Hiroko Otsubo, Shinobu Takahara, Yuko Yamaguchi, Takeshi Saito, Jiro Minami, Yutaro Kamiyama, Noriyuki Morikawa, Tomohito Machishima, Hiroshi Osawa, Keisuke Aiba
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 37 Issue 7 Pg. 1277-82 (Jul 2010) ISSN: 0385-0684 [Print] Japan
• PMID: 20647709 (Publication Type: English Abstract, Journal Article)

Chemical References

• Antimetabolites, Antineoplastic
• Methotrexate

Topics

• Adult
• Aged
• Antimetabolites, Antineoplastic (therapeutic use)
• Brain Neoplasms (drug therapy, radiotherapy)
• Central Nervous System Neoplasms (drug therapy, radiotherapy)
• Disease-Free Survival
• Female
• Humans
• Lymphoma (drug therapy, radiotherapy)
• Male
• Methotrexate (adverse effects, therapeutic use)
• Middle Aged
• Retrospective Studies
• Survival Rate