title: Long-term survival in primary CNS lymphoma treated by high-dose methotrexate monochemotherapy: role of STAT6 activation as prognostic determinant.
abstract: We report a single-center experience of 16 immunocompetent patients diagnosed with primary central nervous system lymphoma and treated with monochemotherapy with high-dose methotrexate (MTX) and deferred radiotherapy. MTX was given at a dose of 8.0 g/m2 for induction and at a dose of 3.5-8.0 g/m2 for maintenance. There were eight complete responses (CR), one partial response, one stable disease, and six patients whose tumors progressed in spite of the chemotherapy. At final follow-up, five of five CRs were alive and well without radiotherapy, with median follow-up of 26 months. Overall survival in eight non-CRs treated with the subsequent radiotherapy was 36 months. In the immunohistochemical study, STAT6 was positively expressed in 8 out of 13 cases. They included all non-CRs and two CRs. This observation suggests that STAT6 expression can be used as a prognostic determinant for MTX chemotherapy.
authors.affiliation: Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea, Suwon, South Korea.
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Yang
authors.forename: Kun Soo
authors.initials: KS
authors.lastname: Lee
authors.forename: Il Sup
authors.initials: IS
authors.lastname: Kim
authors.forename: Jae Taek
authors.initials: JT
authors.lastname: Hong
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Sung
authors.forename: Byung Chul
authors.initials: BC
authors.lastname: Son
authors.forename: Sang Won
authors.initials: SW
authors.lastname: Lee
authors.forename: Yong-Kil
authors.initials: YK
authors.lastname: Hong
mesh_terms: D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D014408:Biomarkers, Tumor / Q000032:analysis; D016543:Central Nervous System Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000401:mortality; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000378:metabolism* / Q000401:mortality; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage*; D008875:Middle Aged; D011379:Prognosis; D050800:STAT6 Transcription Factor / Q000378:metabolism*
chemical_list: D000964:Antimetabolites, Antineoplastic; D014408:Biomarkers, Tumor; D050800:STAT6 Transcription Factor; C494101:STAT6 protein, human; D008727:Methotrexate