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Prognostic impact of completion of initial high-dose methotrexate therapy on primary central nervous system lymphoma: a single institution experience

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Abstract

Background

This retrospective single-center study assessed the feasibility, outcomes, and side-effects of high-dose methotrexate (HD-MTX) plus procarbazine in the treatment of immunocompetent patients with primary central nervous system lymphoma (PCNSL).

Methods

Ninety-one patients diagnosed with PCNSL between January 2001 and December 2011 were treated with HD-MTX plus procarbazine. To reduce neurotoxicity in patients aged ≥60 years, only those not responding to chemotherapy and patients with relapse underwent whole-brain irradiation.

Results

All 91 consecutive patients were scheduled to receive HD-MTX. Their median age was 66 years (range 32–88 years) and their median Karnofsky performance score was 40 (range 20–100). While 56 patients (61.5 %) completed 3 cycles of HD-MTX chemotherapy and 48 (52.7 %) showed a complete response, treatment was stopped in 11 patients (12.1 %) due to toxicity. The median overall survival and progression-free survival were 40.6 and 11.7 months, respectively. Overall survival was significantly improved in patients who completed 3 cycles of chemotherapy compared with those did not (56.4 vs 24.0 months; p = 0.013 by univariate and p = 0.022 by multivariate analysis).

Conclusions

Initial treatment with HD-MTX plus procarbazine was effective in patients with PCNSL. Completion of 3 cycles of HD-MTX chemotherapy was a significant independent prognostic factor for patient survival.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurosurgery, Faculty of Medicine, Kumamoto University, 1-1-1 Honjo Chuo-ku, Kumamoto, 860-8556, Japan

    Keishi Makino, Hideo Nakamura, Taku-ichiro Hide, Jun-ichiro Kuroda, Shigetoshi Yano & Jun-ichi Kuratsu

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  1. Keishi Makino
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  2. Hideo Nakamura
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  3. Taku-ichiro Hide
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  4. Jun-ichiro Kuroda
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  5. Shigetoshi Yano
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  6. Jun-ichi Kuratsu
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Corresponding author

Correspondence to Keishi Makino.

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Makino, K., Nakamura, H., Hide, Ti. et al. Prognostic impact of completion of initial high-dose methotrexate therapy on primary central nervous system lymphoma: a single institution experience. Int J Clin Oncol 20, 29–34 (2015). https://doi.org/10.1007/s10147-014-0692-4

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  • DOI: https://doi.org/10.1007/s10147-014-0692-4

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