title: [High-dose methotrexate followed by whole-brain irradiation for primary central nervous system lymphoma patients--a retrospective study in a single institute].
abstract: This study analyzed retrospectively the clinical efficacy of combined therapy consisting of high-dose methotrexate (MTX), administered at a dose of 4 g/m2 every 2 weeks (maximum of 4 courses), followed by whole-brain irradiation for newly diagnosed primary central nervous system lymphoma (PCNSL) patients. Fifteen patients (median age: 59 years old; range: 26-79) were diagnosed by histological examinations or imaging techniques in our hospital. Of 15 patients, 12 (6: complete response; 6: partial response) achieved objective response, and the response rate was 80% (95% CI, 51.9-95.7%). The median follow-up time was 20 (range: 3-81) months, and the 3-year survival rate was 76%. The overall survival time was 71 months (95% CI, 23. 7-118.3 months), and the progression free survival was 15 months (95% CI, 0-43.8 months). The major toxicity (grade>or=3) of high-dose MTX included cytopenia (20%), acute respiratory distress syndrome (6.7%), and liver damage (6.7%). No patient evidenced complicated leukoencephalopathy in the follow-up time. The combined therapy of high-dose MTX followed by whole-brain irradiation showed a substantial antitumor efficacy in PCNSL patients. Prospective studies are required to determine the suitable treatment schedule for MTX and irradiation.
authors.affiliation: Division of Clinical Oncology and Hematology, Department of Internal Medicine, The Jikei University School of Medicine.
authors.forename: Noriko
authors.initials: N
authors.lastname: Usui
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Dobashi
authors.forename: Shingo
authors.initials: S
authors.lastname: Yano
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yahagi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Takei
authors.forename: Hiroko
authors.initials: H
authors.lastname: Otsubo
authors.forename: Shinobu
authors.initials: S
authors.lastname: Takahara
authors.forename: Yuko
authors.initials: Y
authors.lastname: Yamaguchi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Saito
authors.forename: Jiro
authors.initials: J
authors.lastname: Minami
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Kamiyama
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Morikawa
authors.forename: Tomohito
authors.initials: T
authors.lastname: Machishima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Osawa
authors.forename: Keisuke
authors.initials: K
authors.lastname: Aiba
mesh_terms: D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D016543:Central Nervous System Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy* / Q000532:radiotherapy; D008297:Male; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate