[High-dose methotrexate followed by whole-brain irradiation for primary central nervous system lymphoma patients-a retrospective study in a single institute.]
This study analyzedretrospectively the clinical efficacy of combinedtherapy 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>/=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 combinedtherapy 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.
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