Impact of systemic and radiation therapy on survival of primary central nervous system lymphoma Journal Article
| Authors: | Janopaul-Naylor, J. R.; Patel, J. S.; Rupji, M.; Hoang, K. B.; McCall, N. S.; Qian, D. C.; Shoaf, M. L.; Kothari, S.; Olson, J. J.; Shu, H. K. G.; Voloschin, A.; Zhong, J.; Neill, S. G.; Eaton, B. |
| Article Title: | Impact of systemic and radiation therapy on survival of primary central nervous system lymphoma |
| Abstract: | Introduction: Treatment for primary central nervous system lymphoma (PCNSL) includes high-dose methotrexate (HD-MTX)-based systemic therapy. Multiple regimens exist with no clear standard of care. We evaluated the impact of different therapies on PCNSL outcomes at a single institution. Materials and Methods: A total of 95 consecutive patients with PCNSL from 2002 to 2021 were retrospectively reviewed. The overall survival (OS) and progression-free survival (PFS) were estimated by the Kaplan–Meier method. The log-rank test and univariate and multivariable Cox regression analysis were used to evaluate the relationship between clinicopathologic and treatment variables with outcomes. Results: Among the 62 patients treated with definitive systemic therapy, the median age was 58; 71% had a Karnofsky performance status > 70, 49% had a single lesion, 31% received HD-MTX alone, and 61% had HD-MTX + rituximab. The two-year OS and PFS were 64% (95% CI: 49.8–75.0%) and 49% (95% CI: 35.0–60.9%), respectively. On multivariable analysis, the completion of > six cycles of HD-MTX (HR 0.40; 95% CI: 0.21–0.76; p = 0.01) was associated with superior OS, while the use of rituximab was associated with inferior OS (HR 2.82; 95% CI: 1.37–5.83; p = 0.01). There were no significant associations between the OS and PFS with temozolomide, the extent of surgical resection, radiation, or the size or number of initial lesions (all p > 0.05). Discussion: Innovation is needed to improve the outcomes for patients with PCNSL. © 2025 by the authors. |
| Keywords: | adult; cancer chemotherapy; aged; survival analysis; major clinical study; overall survival; systemic therapy; primary central nervous system lymphoma; cytarabine; methotrexate; rituximab; temozolomide; nuclear magnetic resonance imaging; progression free survival; cohort analysis; retrospective study; biopsy; histology; thiotepa; disease exacerbation; descriptive research; pcnsl; very elderly; human; male; female; article; wbrt; bulky disease |
| Journal Title: | Cancers |
| Volume: | 17 |
| Issue: | 4 |
| ISSN: | 2072-6694 |
| Publisher: | MDPI |
| Date Published: | 2025-02-02 |
| Start Page: | 618 |
| Language: | English |
| DOI: | 10.3390/cancers17040618 |
| PROVIDER: | scopus |
| PMCID: | PMC11853249 |
| PUBMED: | 40002213 |
| DOI/URL: | |
| Notes: | Article -- MSK corresponding author is James Robert Janopaul-Naylor -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
Related MSK Work