title: Treatment of Primary Central Nervous System Lymphoma with High-dose Methotrexate and Radiotherapy in HIV-negative Patients.
abstract: BACKGROUND
  We assessed the outcome of high-dose methotrexate (HD-MTX) chemotherapy with or without radiotherapy (RT) in primary central nervous system lymphoma (PCNSL) patients.
  
  
  METHODS
  Fifty-one HIV-negative patients with an average age of 50.3 years were treated with chemotherapy regimen included 2500 mg/m(2) MTX with Leucovorin rescue and 1.4 mg/m(2) vincristine (day two), which was administered every other week for 6 weeks. Only the patients who were younger than 60 years received RT. All patients received two cycles of 3000 mg/m(2) cytarabine at the end of the treatment for two successive days.
  
  
  RESULTS
  Diffuse large B-cell lymphoma was the most common histologic subtype (90.2%), and twenty-six (51.0%)patients had multiple brain lesions. The median survival of patients who were younger than 60 years was 37 months. For patients who were older than 60 years, the median survival was 20 months. The median survival of men and women were 30 and 34 months, respectively. There was no significant difference in survival of patients in terms of age and sex. Overall, sixteen patients (31%) out of fifty-one patients died, five of them were older than 60 years and eleven were younger than 60 years. Twenty-five (49%) of all patients experienced relapse, and 10 (40%) of them died after rechemotherapy.
  
  
  CONCLUSIONS
  The base of our chemotherapy regimen was HD-MTX as the regular doses of MTX cannot penetrate the blood brain barrier (BBB). Our results indicated that the combination of HD-MTX with RT may not influence the outcome of PCNSL; thus, RT cannot be the first line therapy.
authors: AJA Cancer Research Center (ACRC), AJA University of Medical Sciences, Tehran, Iran.
authors: Hasan
authors: H
authors: Jalaeikhoo
authors: Department of Epidemiology and Biostatics, School of Public Health, Tehran University of Medical Science, Tehran, Iran.
authors: Mir Saeed
authors: MS
authors: Yekaninejad
authors: Diagnostic Laboratory, Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Saeideh
authors: S
authors: Hajizamani
authors: Health Research Institute, Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors: Fakher
authors: F
authors: Rahim
authors: Health Research Institute, Research Center of Thalassemia and Hemoglobinopathy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. ahmad.ahmadzadeh@gmail.com.
authors: Ahmad
authors: A
authors: Ahmadzadeh
authors: Hematology and Oncology Research Center, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors: Manoutchehr
authors: M
authors: Keyhani
authors: Arad Hospital, Tehran, Iran.
authors: Behrooz
authors: B
authors: Sadeghi Hariri
authors: Health Research Institute, Research Center of Thalassemia and Hemoglobinopathy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors: Najmaldin
authors: N
authors: Saki
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D016543:Central Nervous System Neoplasms / Q000401:mortality* / Q000628:therapy*; D003561:Cytarabine / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008223:Lymphoma / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage*; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D000964:Antimetabolites, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D003561:Cytarabine; D014750:Vincristine; D002955:Leucovorin; D008727:Methotrexate