Journal ArticleDOI
Combination Chemotherapy and Radiotherapy for Primary Central Nervous System Lymphoma: Radiation Therapy Oncology Group Study 93-10
TLDR
This is the first multicenter trial demonstrating improved survival with the combination of chemotherapy plus RT compared with previous reports of RT alone, and high-dose methotrexate combined with cranial irradiation is an effective therapeutic approach to PCNSL, but neurotoxicity is a delayed risk of this approach.Abstract:
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/m2, 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 patie...read more
Citations
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Journal ArticleDOI
Report of an International Workshop to Standardize Baseline Evaluation and Response Criteria for Primary CNS Lymphoma
Lauren E. Abrey,Tracy T. Batchelor,A. J. M. Ferreri,Mary Gospodarowicz,Elisa Jacobsen Pulczynski,Emanuele Zucca,Justine R. Smith,Agnieszka Korfel,Carole Soussain,Lisa M. DeAngelis,Edward A. Neuwelt,Brian P. O'Neill,Eckhard Thiel,Tamara Shenkier,Fransesc Graus,Martin J. van den Bent,John F. Seymour,Philip Poortmans,James O. Armitage,Franco Cavalli +19 more
TL;DR: An international group of experts meeting to review current standards of reporting and to formulate a consensus opinion regarding minimum baseline evaluation and common standards for assessing response to therapy hope that these guidelines will improve communication among investigators and comparability among clinical trials in a way that will allow to develop better therapies for patients.
Journal ArticleDOI
High-dose cytarabine plus high-dose methotrexate versus high-dose methotrexate alone in patients with primary CNS lymphoma: a randomised phase 2 trial.
Andrés J.M. Ferreri,Michele Reni,Marco Foppoli,Maurizio Martelli,Gerasimus A. Pangalis,Maurizio Frezzato,Maria Giuseppina Cabras,Alberto Fabbri,Gaetano Corazzelli,Fiorella Ilariucci,Giuseppe Rossi,Riccardo Soffietti,Caterina Stelitano,Daniele Vallisa,Francesco Zaja,Lucia Zoppegno,Gian Marco Aondio,Giuseppe Avvisati,Monica Balzarotti,Alba A. Brandes,José Luis Crespo Fajardo,Henry L. Gomez,Attilio Guarini,Graziella Pinotti,Luigi Rigacci,Catrina Uhlmann,Piero Picozzi,Paolo Vezzulli,Maurilio Ponzoni,Emanuele Zucca,Federico Caligaris-Cappio,Franco Cavalli +31 more
TL;DR: In patients aged 75 years and younger with primary CNS lymphoma, the addition of high-dose cytarabine to high- dose methotrexate provides improved outcome with acceptable toxicity compared with high- doses of metotrexate alone.
Journal ArticleDOI
High-dose methotrexate with or without whole brain radiotherapy for primary CNS lymphoma (G-PCNSL-SG-1): a phase 3, randomised, non-inferiority trial
Eckhard Thiel,Agnieszka Korfel,Peter Martus,Lothar Kanz,Frank Griesinger,Michael Rauch,Alexander Röth,Bernd Hertenstein,Theda von Toll,Thomas Hundsberger,H. Mergenthaler,Malte Leithäuser,Tobias Birnbaum,Lars Fischer,Kristoph Jahnke,Ulrich Herrlinger,Ludwig Plasswilm,Thomas Nägele,Torsten Pietsch,Michael Bamberg,Michael Weller,Michael Weller +21 more
TL;DR: The hypothesis was that the omission of whole brain radiotherapy does not compromise overall survival, with a non-inferiority margin of 0·9, and the primary hypothesis was not proven.
Journal ArticleDOI
Nanotechnology-based combinational drug delivery: an emerging approach for cancer therapy
TL;DR: The sustained, controlled and targeted delivery of chemotherapeutic drugs in a combination approach enhanced therapeutic anticancer effects with reduced drug-associated side effects is summarized.
Journal ArticleDOI
Primary Central Nervous System Lymphoma: The Memorial Sloan-Kettering Cancer Center Prognostic Model
Lauren E. Abrey,Leah Ben-Porat,Katherine S. Panageas,Joachim Yahalom,Brian Berkey,Walter J. Curran,Christopher J. Schultz,Steven A. Leibel,Diana F. Nelson,Minesh P. Mehta,Lisa M. DeAngelis +10 more
TL;DR: The MSKCC prognostic score is a simple, statistically powerful model with universal applicability to patients with newly diagnosed PCNSL and is recommended that it be adopted for the management of newly diagnosed patients and incorporated into the design of prospective clinical trials.
References
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Journal ArticleDOI
Treatment for Primary CNS Lymphoma: The Next Step
TL;DR: Increasing the dose of MTX and adding procarbazine and vincristine improved disease control and overall survival in patients with newly diagnosed PCNSL and younger patients in particular fared extremely well with this treatment regimen.
Journal ArticleDOI
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TL;DR: Combined modality therapy for PCNSL has improved survival, but relapse is common and late neurologic toxicity is a significant complication, and efficacious but less neurotoxic regimens need to be developed for older patients.
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