title: Long-term follow-up of an age-adapted C5R protocol followed by radiotherapy in 99 newly diagnosed primary CNS lymphomas: a prospective multicentric phase II study of the Groupe d'Etude des Lymphomes de l'Adulte (GELA).
abstract: BACKGROUND
  This prospective multicentric phase II study aimed to confirm the results of the C5R protocol of high-dose methotrexate (MTX)-based chemotherapy (CT) for immunocompetent primary central nervous system lymphoma.
  
  
  METHODS
  A total of 99 patients received age-adapted CT (C5R protocol) followed by radiotherapy. Patients younger than 61 years (group 1, n = 45) received the full C5R with MTX, doxorubicin, vincristine, cyclophosphamide, and cytarabine. Patients aged 61-70 years (group 2, n = 36) received reduced doses. Patients older than 70 years (group 3, n = 18) received four courses of MTX, cyclophosphamide, and etoposide.
  
  
  RESULTS
  Median age was 63 years and 51% of patients had performance status of more than one. Seventeen patients died of toxicity during CT. Complete response was achieved in 56%, 53%, and 28% of patients in groups 1, 2, and 3, respectively. With a median follow-up of 83 months, the 5-year progression-free survival was 31%, 28%, and 11% and the 5-year overall survival 42%, 31%, and 17% for groups 1, 2, and 3, respectively. Leukoencephalopathy occurred in 32% of assessable patients, in both group 1 and groups 2-3.
  
  
  CONCLUSIONS
  The C5R protocol was feasible in the multicentric setting with favorable long-term survival in patients younger than 60 years. Despite dose adaptation, results in older patients were disappointing.
authors.affiliation: Department of Hematology. Electronic address: ghesquie@lyon.fnclcc.fr.
authors.forename: H
authors.initials: H
authors.lastname: Ghesquières
authors.affiliation: Biostatistics Unit, Centre Léon Bérard, Université de Lyon, Lyon.
authors.forename: C
authors.initials: C
authors.lastname: Ferlay
authors.affiliation: Department of Hematology.
authors.forename: C
authors.initials: C
authors.lastname: Sebban
authors.affiliation: Biostatistics Unit, Centre Léon Bérard, Université de Lyon, Lyon.
authors.forename: D
authors.initials: D
authors.lastname: Perol
authors.affiliation: Department of Hematology, UCL Mont Godine, Yvoir, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Bosly
authors.affiliation: Department of Hematology, Centre Hospitalier Universitaire, Dijon.
authors.forename: O
authors.initials: O
authors.lastname: Casasnovas
authors.affiliation: Department of Hematology, Centre Hospitalier, Caen.
authors.forename: O
authors.initials: O
authors.lastname: Reman
authors.affiliation: Department of Clinical Hematology, Centre Hospitalier Lyon-Sud, Pierre Benite.
authors.forename: B
authors.initials: B
authors.lastname: Coiffier
authors.affiliation: Department of Hematology, Centre Henri Becquerel, Rouen.
authors.forename: H
authors.initials: H
authors.lastname: Tilly
authors.affiliation: Department of Hematology, Hôpital Schaffner, Lens, France.
authors.forename: P
authors.initials: P
authors.lastname: Morel
authors.affiliation: Department of Clinical Hematology, UCL St Luc, Bruxelles, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Van den Neste
authors.affiliation: Department of Hematology, Clinique Courlancy, Reims.
authors.forename: P
authors.initials: P
authors.lastname: Colin
authors.affiliation: Department of Hematology, CHU Henri Mondor, Créteil, France.
authors.forename: C
authors.initials: C
authors.lastname: Haioun
authors.affiliation: Department of Hematology.
authors.forename: P
authors.initials: P
authors.lastname: Biron
authors.affiliation: Department of Hematology.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Blay
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016543:Central Nervous System Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D012955:Societies, Medical; D013997:Time Factors; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects; D055815:Young Adult
chemical_list: D003561:Cytarabine; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D008727:Methotrexate