Abstract | BACKGROUND: This retrospective single-center study assessed the feasibility, outcomes, and side-effects of high-dose methotrexate (HD-MTX) plus procarbazine in the treatment of immunocompetent patients with primary central nervous system lymphoma (PCNSL). METHODS: Ninety-one patients diagnosed with PCNSL between January 2001 and December 2011 were treated with HD-MTX plus procarbazine. To reduce neurotoxicity in patients aged ≥60 years, only those not responding to chemotherapy and patients with relapse underwent whole-brain irradiation. RESULTS: All 91 consecutive patients were scheduled to receive HD-MTX. Their median age was 66 years (range 32-88 years) and their median Karnofsky performance score was 40 (range 20-100). While 56 patients (61.5 %) completed 3 cycles of HD-MTX chemotherapy and 48 (52.7 %) showed a complete response, treatment was stopped in 11 patients (12.1 %) due to toxicity. The median overall survival and progression-free survival were 40.6 and 11.7 months, respectively. Overall survival was significantly improved in patients who completed 3 cycles of chemotherapy compared with those did not (56.4 vs 24.0 months; p = 0.013 by univariate and p = 0.022 by multivariate analysis). CONCLUSIONS: Initial treatment with HD-MTX plus procarbazine was effective in patients with PCNSL. Completion of 3 cycles of HD-MTX chemotherapy was a significant independent prognostic factor for patient survival.
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Authors | Keishi Makino, Hideo Nakamura, Taku-ichiro Hide, Jun-ichiro Kuroda, Shigetoshi Yano, Jun-ichi Kuratsu |
Journal | International journal of clinical oncology
(Int J Clin Oncol)
Vol. 20
Issue 1
Pg. 29-34
(Feb 2015)
ISSN: 1437-7772 [Electronic] Japan |
PMID | 24722885
(Publication Type: Journal Article)
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Chemical References |
- Antimetabolites, Antineoplastic
- Antineoplastic Agents
- Procarbazine
- Methotrexate
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Antimetabolites, Antineoplastic
(administration & dosage)
- Antineoplastic Agents
(administration & dosage)
- Antineoplastic Combined Chemotherapy Protocols
(administration & dosage)
- Central Nervous System Neoplasms
(drug therapy)
- Disease-Free Survival
- Female
- Humans
- Lymphoma
(drug therapy)
- Male
- Methotrexate
(administration & dosage)
- Middle Aged
- Procarbazine
(administration & dosage)
- Retrospective Studies
- Treatment Outcome
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