Long-term follow-up of high-dose methotrexate-based therapy with and without whole brain irradiation for newly diagnosed primary CNS lymphoma Journal Article


Authors: Gavrilovic, I. T.; Hormigo, A.; Yahalom, J.; Deangelis, L. M.; Abrey, L. E.
Article Title: Long-term follow-up of high-dose methotrexate-based therapy with and without whole brain irradiation for newly diagnosed primary CNS lymphoma
Abstract: Purpose: We previously reported a series of patients treated with high-dose methotrexate (MTX) -based chemotherapy, with or without whole brain radiotherapy. The purpose of this report is to update the initial results and provide long-term data regarding overall survival, patterns of relapse, and the risk of treatment-related neurotoxicity. Patients and Methods: Fifty-seven patients with an average age of 65 and median Karnofsky performance score of 70 were treated; all patients have been observed longitudinally with serial magnetic resonance imaging scans and neurologic examinations. Results: The overall median survival was 51 months with a median follow-up of 115 months for surviving patients. Twenty-five patients relapsed or developed progressive disease; median progression-free survival was 129 months. Seventeen patients developed treatment-related neurotoxicity; all but one had received whole brain radiotherapy as a component of treatment. Seventy-four percent of patients younger than 60 years who received both MTX-based chemotherapy and whole brain radiotherapy were alive at last follow-up. Median survival for patients older than 60 years was 29 months regardless of whether or not they received whole brain radiotherapy. Conclusion: Long-term follow-up of our initial cohort confirms the observation of excellent overall survival, particularly for those patients younger than age 60 at diagnosis. For older patients, it appears to be reasonable to defer whole brain radiotherapy in an effort to minimize treatment-related neurotoxicity. © 2006 by American Society of Clinical Oncology.
Keywords: adult; cancer chemotherapy; cancer survival; controlled study; treatment outcome; aged; aged, 80 and over; disease-free survival; middle aged; major clinical study; mortality; disease free survival; methotrexate; brain radiation; drug megadose; neurotoxicity; follow up; cohort studies; cohort analysis; age factors; drug effect; central nervous system tumor; radiation exposure; age; central nervous system neoplasms; brain; lymphoma; brain lymphoma
Journal Title: Journal of Clinical Oncology
Volume: 24
Issue: 28
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2006-10-01
Start Page: 4570
End Page: 4574
Language: English
DOI: 10.1200/jco.2006.06.6910
PUBMED: 17008697
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 78" - "Export Date: 4 June 2012" - "CODEN: JCOND" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Joachim Yahalom
    398 Yahalom
  2. Adilia Hormigo
    48 Hormigo
  3. Lauren E Abrey
    272 Abrey