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Primary central nervous system lymphoma: The role of consolidation treatment after a complete response to high-dose methotrexate-based chemotherapy†

  1. Meltem Ekenel MD1,‡,
  2. Fabio M. Iwamoto MD1,‡,
  3. Leah S. Ben-Porat MS2,
  4. Katherine S. Panageas DrPH2,
  5. Joachim Yahalom MD3,
  6. Lisa M. DeAngelis MD1,
  7. Lauren E. Abrey MD1,§,*

Article first published online: 10 JUL 2008

DOI: 10.1002/cncr.23670

Issue

Cancer

Cancer

Volume 113, Issue 5, pages 1025–1031, 1 September 2008

Additional Information

How to Cite

Ekenel, M., Iwamoto, F. M., Ben-Porat, L. S., Panageas, K. S., Yahalom, J., DeAngelis, L. M. and Abrey, L. E. (2008), Primary central nervous system lymphoma: The role of consolidation treatment after a complete response to high-dose methotrexate-based chemotherapy. Cancer, 113: 1025–1031. doi: 10.1002/cncr.23670

Author Information

  1. 1

    Departments of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York

  2. 2

    Department of Epidemiology-Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York

  3. 3

    Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York

  1. ‡

    The first 2 authors contributed equally to this work.

  2. §

    Fax: (917) 432-2310;

*Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065

  1. †

    Presented in part at the 43rd American Society of Clinical Oncology Annual Meeting, Chicago, Illinois, June 1–5, 2007.

Publication History

  1. Issue published online: 20 AUG 2008
  2. Article first published online: 10 JUL 2008
  3. Manuscript Accepted: 14 APR 2008
  4. Manuscript Revised: 7 APR 2008
  5. Manuscript Received: 5 FEB 2008

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REFERENCES

  • 1
    Nelson DF,Martz KL,Bonner H, et al. Non-Hodgkin's lymphoma of the brain: can high dose, large volume radiation therapy improve survival? Report on a prospective trial by the Radiation Therapy Oncology Group (RTOG): RTOG 8315. Int J Radiat Oncol Biol Phys. 1992; 23: 9–17.
  • 2
    Shibamoto Y,Ogino H,Hasegawa M, et al. Results of radiation monotherapy for primary central nervous system lymphoma in the 1990s. Int J Radiat Oncol Biol Phys. 2005; 62: 809–813.
  • 3
    Abrey LE,Yahalom J,DeAngelis LM. Treatment for primary CNS lymphoma: the next step. J Clin Oncol. 2000; 18: 3144–3150.
  • 4
    DeAngelis LM,Seiferheld W,Schold SC,Fisher B,Schultz CJ. Combination chemotherapy and radiotherapy for primary central nervous system lymphoma: Radiation Therapy Oncology Group Study 93-10. J Clin Oncol. 2002; 20: 4643–4648.
  • 5
    Gavrilovic IT,Hormigo A,Yahalom J,DeAngelis LM,Abrey LE. Long-term follow-up of high-dose methotrexate-based therapy with and without whole brain irradiation for newly diagnosed primary CNS lymphoma. J Clin Oncol. 2006; 24: 4570–4574.
  • 6
    O'Brien P,Roos D,Pratt G, et al. Phase II multicenter study of brief single-agent methotrexate followed by irradiation in primary CNS lymphoma. J Clin Oncol. 2000; 18: 519–526.
  • 7
    Omuro AM,DeAngelis LM,Yahalom J,Abrey LE. Chemoradiotherapy for primary CNS lymphoma: an intent-to-treat analysis with complete follow-up. Neurology. 2005; 64: 69–74.
  • 8
    Poortmans PM,Kluin-Nelemans HC,Haaxma-Reiche H, et al. High-dose methotrexate-based chemotherapy followed by consolidating radiotherapy in non-AIDS-related primary central nervous system lymphoma: European Organization for Research and Treatment of Cancer Lymphoma Group Phase II Trial 20962. J Clin Oncol. 2003; 21: 4483–4488.
  • 9
    Abrey LE,DeAngelis LM,Yahalom J. Long-term survival in primary CNS lymphoma. J Clin Oncol. 1998; 16: 859–863.
  • 10
    Batchelor T,Carson K,O'Neill A, et al. Treatment of primary CNS lymphoma with methotrexate and deferred radiotherapy: a report of NABTT 96-07. J Clin Oncol. 2003; 21: 1044–1049.
  • 11
    Herrlinger U,Kuker W,Uhl M, et al. NOA-03 trial of high-dose methotrexate in primary central nervous system lymphoma: final report. Ann Neurol. 2005; 57: 843–847.
    Direct Link:
  • 12
    Herrlinger U,Schabet M,Brugger W, et al. German Cancer Society Neuro-Oncology Working Group NOA-03 multicenter trial of single-agent high-dose methotrexate for primary central nervous system lymphoma. Ann Neurol. 2002; 51: 247–252.
    Direct Link:
  • 13
    Hoang-Xuan K,Taillandier L,Chinot O, et al. Chemotherapy alone as initial treatment for primary CNS lymphoma in patients older than 60 years: a multicenter phase II study of the European Organization for Research and Treatment of Cancer Brain Tumor Group. J Clin Oncol. 2003; 21: 2726–2731.
  • 14
    Pels H,Schmidt-Wolf IG,Glasmacher A, et al. Primary central nervous system lymphoma: results of a pilot and phase II study of systemic and intraventricular chemotherapy with deferred radiotherapy. J Clin Oncol. 2003; 21: 4489–4495.
  • 15
    Sandor V,Stark-Vancs V,Pearson D, et al. Phase II trial of chemotherapy alone for primary CNS and intraocular lymphoma. J Clin Oncol. 1998; 16: 3000–3006.
  • 16
    Gray R. A Class of K-sample tests for comparing the cumulative incidence of a competing risk. Ann Stat. 1988; 16: 1141–1154.
  • 17
    Fine JP,Gray RJ. A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc. 1999; 94: 496–509.
  • 18
    Plotkin SR,Betensky RA,Hochberg FH, et al. Treatment of relapsed central nervous system lymphoma with high-dose methotrexate. Clin Cancer Res. 2004; 10: 5643–5646.
  • 19
    Nguyen PL,Chakravarti A,Finkelstein DM,Hochberg FH,Batchelor TT,Loeffler JS. Results of whole-brain radiation as salvage of methotrexate failure for immunocompetent patients with primary CNS lymphoma. J Clin Oncol. 2005; 23: 1507–1513.
  • 20
    Ferreri AJ,Reni M,Pasini F, et al. A multicenter study of treatment of primary CNS lymphoma. Neurology. 2002; 58: 1513–1520.
  • 21
    Reni M,Ferreri AJ,Guha-Thakurta N, et al. Clinical relevance of consolidation radiotherapy and other main therapeutic issues in primary central nervous system lymphomas treated with upfront high-dose methotrexate. Int J Radiat Oncol Biol Phys. 2001; 51: 419–425.
  • 22
    Bessell EM,Lopez-Guillermo A,Villa S, et al. Importance of radiotherapy in the outcome of patients with primary CNS lymphoma: an analysis of the CHOD/BVAM regimen followed by 2 different radiotherapy treatments. J Clin Oncol. 2002; 20: 231–236.
  • 23
    DeAngelis LM,Kreis W,Chan K,Dantis E,Akerman S. Pharmacokinetics of ara-C and ara-U in plasma and CSF after high-dose administration of cytosine arabinoside. Cancer Chemother Pharmacol. 1992; 29: 173–177.
  • 24
    Frick JC,Hansen RM,Anderson T,Ritch PS. Successful high-dose intravenous cytarabine treatment of parenchymal brain involvement from malignant lymphoma. Arch Intern Med. 1986; 146: 791–792.
  • 25
    Recht L,Straus DJ,Cirrincione C,Thaler HT,Posner JB. Central nervous system metastases from non-Hodgkin's lymphoma: treatment and prophylaxis. Am J Med. 1988; 84: 425–435.
  • 26
    Shah GD,Yahalom J,Correa DD, et al. Combined immunochemotherapy with reduced whole-brain radiotherapy for newly diagnosed primary CNS lymphoma. J Clin Oncol. 2007; 25: 4730–4735.
  • 27
    Abrey LE,Moskowitz CH,Mason WP, et al. Intensive methotrexate and cytarabine followed by high-dose chemotherapy with autologous stem-cell rescue in patients with newly diagnosed primary CNS lymphoma: an intent-to-treat analysis. J Clin Oncol. 2003; 21: 4151–4156.
  • 28
    Illerhaus G,Marks R,Ihorst G, et al. High-dose chemotherapy with autologous stem-cell transplantation and hyperfractionated radiotherapy as first-line treatment of primary CNS lymphoma. J Clin Oncol. 2006; 24: 3865–3870.
  • 29
    Illerhaus G,Muller F,Feuerhake F,Schafer AO,Ostertag C,Finke J. High-dose chemotherapy and autologous stem-cell transplantation without consolidating radiotherapy as first-line treatment for primary lymphoma of the central nervous system. Haematologica. 2008; 93: 147–148.
  • 30
    Cheng T,Forsyth P,Chaudhry A, et al. High-dose thiotepa, busulfan, cyclophosphamide and ASCT without whole-brain radiotherapy for poor prognosis primary CNS lymphoma. Bone Marrow Transplant. 2003; 31: 679–685.
  • 31
    Colombat P,Lemevel A,Bertrand P, et al. High-dose chemotherapy with autologous stem cell transplantation as first-line therapy for primary CNS lymphoma in patients younger than 60 years: a multicenter phase II study of the GOELAMS group. Bone Marrow Transplant. 2006; 38: 417–420.
  • 32
    Montemurro M,Kiefer T,Schuler F, et al. Primary central nervous system lymphoma treated with high-dose methotrexate, high-dose busulfan/thiotepa, autologous stem-cell transplantation and response-adapted whole-brain radiotherapy: results of the multicenter Ostdeutsche Studiengruppe Hamato-Onkologie OSHO-53 phase II study. Ann Oncol. 2007; 18: 665–671.
  • 33
    http://www.cancer.gov/search/ViewClinicalTrials.aspx?cdrid=301563&version=HealthProfessional&protocolsearchid=4402372. Accessed April 7, 2008.
  • 34
    http://www.cancer.gov/search/ViewClinicalTrials.aspx?cdrid=398106&version=HealthProfessional&protocolsearchid=4402372. Accessed April 7, 2008.
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