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https://hdl.handle.net/2440/9596
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Type: | Journal article |
Title: | Phase II multicenter study of brief single-agent methotrexate followed by irradiation in primary CNS lymphoma |
Author: | O'Brien, P. Roos, D. Pratt, G. Liew, K. Barton, M. Poulsen, M. Olver, I. Trotter, G. |
Citation: | Journal of Clinical Oncology, 2000; 18(3):519-526 |
Publisher: | Amer Soc Clinical Oncology |
Issue Date: | 2000 |
ISSN: | 0732-183X 1527-7755 |
Statement of Responsibility: | P. O’Brien, D. Roos, G. Pratt, K. Liew, M. Barton, M. Poulsen, I. Olver, and G. Trotter |
Abstract: | PURPOSE: To assess, in a multi-institutional setting, the impact on relapse, survival, and toxicity of adding two cycles of intravenous methotrexate to cranial irradiation for immunocompetent patients with primary CNS lymphoma. PATIENTS AND METHODS: Forty-six patients with a median age of 58 years and Eastern Cooperative Oncology Group performance status 0 to 3 were entered onto this phase II study. The protocol consisted of methotrexate 1 g/m2 on days 1 and 8 followed by cranial irradiation on day 15. A whole-brain dose of 45 Gy was followed by a boost of 5.4 Gy. Intrathecal chemotherapy and spinal irradiation were given only to patients for whom cytologic examination of CSF was positive for CNS lymphoma. The median follow-up time was 36 months, with a minimum potential follow-up of 12 months. RESULTS: Median survival was 33 months, with 2-year probability of survival 62% ± 15% (95% confidence interval). Twenty patients have relapsed. The predominant site of relapse was the brain. Neither performance status nor age was found to influence survival. Six patients developed a dementing illness at a median of 16 months after treatment, and three of these died as a consequence. CONCLUSION: A brief course of intravenous methotrexate before cranial irradiation is associated with 2-year and median survival rates superior to those reported for radiotherapy alone and similar to more intensive combined-modality regimens. Neurotoxicity remains an important competing risk for these patient |
Keywords: | Humans Lymphoma Central Nervous System Neoplasms Methotrexate Antimetabolites, Antineoplastic Combined Modality Therapy Cranial Irradiation Infusions, Intravenous Survival Analysis Patient Compliance Adult Aged Middle Aged Female Male |
Rights: | © 2000 American Society for Clinical Oncology |
DOI: | 10.1200/jco.2000.18.3.519 |
Published version: | http://jco.ascopubs.org/cgi/content/abstract/18/3/519 |
Appears in Collections: | Aurora harvest 4 Medicine publications |
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