title: Long-term survival in primary CNS lymphoma.
abstract: OBJECTIVE
  We have previously reported on 31 patients with primary CNS lymphoma (PCNSL) treated between 1986 and 1992 with methotrexate (MTX), cranial radiotherapy (RT), and high-dose cytarabine who remained free of disease longer than historical controls.
  
  
  METHODS
  We performed a follow-up analysis of our original cohort and now report their long-term survival and late treatment-related toxicity.
  
  
  RESULTS
  The median cause-specific survival was 42 months, with a five-year survival of 22.3% compared with 3% to 4% in historical controls treated with RT alone. Age less than 50 years at diagnosis was a significant prognostic factor for survival (P = .01). Median disease-free survival was 40.3 months; 15 patients relapsed, all but one in the CNS. Late treatment-related toxicity was observed in nearly one third of patients and those more than 60 years of age were at substantially higher risk (P < .0001).
  
  
  CONCLUSIONS
  Combined modality therapy for PCNSL has improved survival, but relapse is common and late neurologic toxicity is a significant complication. Although this approach is highly effective for younger patients, efficacious but less neurotoxic regimens need to be developed for older patients.
authors.affiliation: Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
authors.forename: L E
authors.initials: LE
authors.lastname: Abrey
authors.forename: L M
authors.initials: LM
authors.lastname: DeAngelis
authors.forename: J
authors.initials: J
authors.lastname: Yahalom
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016543:Central Nervous System Neoplasms / Q000401:mortality* / Q000628:therapy*; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008223:Lymphoma / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D012074:Remission Induction; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D003561:Cytarabine; D008727:Methotrexate