Chemotherapy without radiation therapy as initial treatment for primary CNS lymphoma in older patients

Neurology
R J FreilichL M DeAngelis

Abstract

Chemotherapy plus radiation therapy (RT) for primary CNS lymphoma (PCNSL) has significantly improved patient survival over RT alone, but there are late neurologic sequelae of RT, particularly in the elderly. We treated 13 patients over age 50 years (mean age 74 years) with chemotherapy alone as initial treatment for PCNSL. All received methotrexate (MTX) and procarbazine; in addition, five received thiotepa, four vincristine, and four vincristine and cytarabine. Ten achieved a complete response (CR), 2 a partial response (PR), and 1 progressed through treatment. Two patients with ocular lymphoma responded to MTX, procarbazine, and vincristine. Four of six patients who relapsed after achieving a CR or PR were treated with additional chemotherapy or RT; three achieved a CR and one a PR. Five patients remain in CR at 7.5 to 30 months, one is alive at 35 months but with progressive disease, six died of PCNSL at 5 to 30.5 months, and one died in CR of sulfur allergy 2 months after diagnosis. The Karnofsky Performance Status improved in 11 to 13 patients with treatment. Cognitive deficits were present in nine patients at diagnosis and improved in eight of these nine after chemotherapy. Only one patient developed new cognitive deficit...Continue Reading

Citations

Feb 1, 1997·Italian Journal of Neurological Sciences·A Boiardi, A Silvani
Jun 9, 2005·Neuroradiology·F J HansT Krings
Aug 12, 2006·Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·M ZierhutC Heinz
Sep 7, 2004·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·Kristoph JahnkeAgnieszka Korfel
Nov 27, 2004·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·Sarah E CouplandNikolaos E Bechrakis
Jan 18, 2006·Journal of Cancer Research and Clinical Oncology·Barbara EberhardtWolfgang H R Miltner
Nov 5, 2005·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Barbara EberhardtWolfgang H R Miltner
Jun 12, 2002·Current Treatment Options in Oncology·L M DeAngelis
Apr 9, 2013·Current Neurology and Neuroscience Reports·Mariza Daras, Lisa M DeAngelis
Apr 3, 2003·Current Treatment Options in Neurology·Denise M. Damek
Nov 30, 2000·Current Treatment Options in Neurology·P A Forsyth, W H Roa
Mar 29, 2002·Survey of Ophthalmology·Russell W ReadNarsing A Rao
Feb 1, 2003·Lancet·Anthony BehinJean-Yves Delattre
Jun 12, 2003·Ophthalmology·John O Mason, David H Fischer
May 31, 2001·International Journal of Radiation Oncology, Biology, Physics·E M BessellP Byrne
Jul 2, 2002·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·U Basso, A A Brandes
Mar 22, 2002·The Lancet Oncology·S R Plotkin, T T Batchelor
Oct 28, 2008·Annals of Oncology : Official Journal of the European Society for Medical Oncology·G IllerhausJ Finke
Sep 6, 2000·Spine·H PelsU Schlegel
Apr 15, 2006·The Cancer Journal·Joachim M Baehring, Fred H Hochberg
Sep 26, 2003·Transplantation·Renaud SnanoudjBernard Charpentier
Sep 2, 2008·Neuro-oncology·Jay-Jiguang ZhuTracy T Batchelor
Dec 1, 2006·Neurosurgical Focus·Marc C Chamberlain
Dec 1, 2006·Neurosurgical Focus·Oussama Abla, Sheila Weitzman
Feb 17, 2000·Current Opinion in Neurology·L M DeAngelis
Oct 25, 2013·Expert Review of Anticancer Therapy·Giovanni CitterioMichele Reni
Jan 5, 2002·Expert Opinion on Pharmacotherapy·Deric Minwoo Park, Lauren E Abrey
Dec 18, 2013·Seminars in Oncology·Jeanne S MandelblattUNKNOWN Thinking and Living With Cancer Study

❮ Previous
Next ❯

Related Concepts

Related Feeds

CNS Lymphoma

In CNS lymphoma, cancerous cells from lymph tissues or other parts of the body form tumors in the brain and/or spinal cord. Here is the latest research on this rare non-Hodgkin lymphoma.