title: Prospective trial on topotecan salvage therapy in primary CNS lymphoma.
abstract: BACKGROUND
  Standard salvage therapy has not been established for recurrent primary central nervous system lymphoma (PCNSL). We report the final results of a prospective study on topotecan chemotherapy in relapsed or refractory PCNSL.
  
  
  METHODS
  The study included 27 patients with a median age of 51 years and an ECOG performance status of 2. Fourteen patients were refractory to the last therapy, and 13 relapsed after a median period of 6.0 months. Pretreatment with up to four regimens included chemotherapy in 26 patients and whole brain irradiation in 14. A 30-min daily topotecan infusion of 1.5 mg/m(2) for 5 days was repeated every 3 weeks.
  
  
  RESULTS
  The response rate was 33% with five complete (CR) and four partial remissions (PR). The median follow-up was 37.7 months. All complete responders had sustained remissions lasting for 9 to 28 months. The median event-free survival (EFS) was 2.0 months (9.1 months in responders), the overall survival (OAS) was 8.4 months. CTC grade 3-4 leukopenia occurred in 26% and thrombocytopenia in 11% of the patients. Eight of 12 patients alive without cerebral lymphoma > or = six months after topotecan exhibited deficits attributable to late neurotoxicity.
  
  
  CONCLUSIONS
  Topotecan as monotherapy is active in relapsed and refractory PCNSL with tolerable toxicity.
authors.affiliation: Department of Haematology, Oncology and Transfusion Medicine, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Germany. lars.fischer@charite.de
authors.forename: L
authors.initials: L
authors.lastname: Fischer
authors.forename: E
authors.initials: E
authors.lastname: Thiel
authors.forename: H-A
authors.initials: HA
authors.lastname: Klasen
authors.forename: J
authors.initials: J
authors.lastname: Birkmann
authors.forename: K
authors.initials: K
authors.lastname: Jahnke
authors.forename: P
authors.initials: P
authors.lastname: Martus
authors.forename: A
authors.initials: A
authors.lastname: Korfel
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016543:Central Nervous System Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000401:mortality; D011446:Prospective Studies; D012074:Remission Induction; D016879:Salvage Therapy; D016019:Survival Analysis; D019772:Topotecan / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D019772:Topotecan