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.

Détails

ID Serval
serval:BIB_4626E02D3AC8
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
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.
Périodique
Annals of Oncology
Auteur(s)
Montemurro M., Kiefer T., Schüler F., Al-Ali H.K., Wolf H.H., Herbst R., Haas A., Helke K., Theilig A., Lotze C., Hirt C., Niederwieser D., Schwenke M., Krüger W.H., Dölken G.
ISSN
0923-7534 (Print)
ISSN-L
0923-7534
Statut éditorial
Publié
Date de publication
2007
Volume
18
Numéro
4
Pages
665-671
Langue
anglais
Notes
Publication types: Clinical Trial, Phase II ; Journal Article ; Multicenter Study
Publication Status: ppublish
Résumé
BACKGROUND: We investigated the efficacy and safety of tandem high-dose methotrexate (HD-MTX) induction followed by high-dose busulfan/thiotepa (HD-BuTT) with autologous peripheral blood stem-cell transplantation (aPBSCT) and response-adapted whole-brain radiation therapy (WBRT) in patients with newly diagnosed primary central nervous system lymphoma.
PATIENTS AND METHODS: Twenty-three patients were treated with HD-MTX on days 1 and 10. In case of at least a partial remission (PR), HD-BuTT followed by aPBSCT was given. Patients without response to induction or without complete remission (CR) after HD-BuTT received WBRT.
RESULTS: Sixteen patients received HD-MTX and HD-BuTT achieving a CR/PR rate of 69%/13%. CR/PR rates for all patients (n = 23) were 70%/13%. There were three deaths during therapy. With longer follow-up three neurotoxic deaths occurred in irradiated patients (n = 9), while no persistent neurotoxicity was seen after HD-BuTT without subsequent WBRT. At a median follow-up of 15 months (range 1-69) median event-free survival (EFS) and overall survival (OS) for all patients were 17 and 20 months (Kaplan-Meier), after HD-BuTT 27 months and "not reached", respectively. Estimated 2-year EFS and OS were 45% and 48% for all patients versus 56% and 61% for the HD-BuTT group, respectively.
CONCLUSION: MTX induction followed by HD-BuTT is an effective and very short time-on-treatment regimen. Median survival for patients treated with high-dose chemotherapy is not reached yet. The induction regimen needs optimisation. In this study WBRT was associated with a high incidence of severe neurotoxicity.
Mots-clé
Adolescent, Adult, Aged, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Busulfan/administration & dosage, Central Nervous System Neoplasms/mortality, Central Nervous System Neoplasms/therapy, Combined Modality Therapy, Cranial Irradiation, Female, Humans, Lymphoma/mortality, Lymphoma/therapy, Male, Methotrexate/administration & dosage, Middle Aged, Peripheral Blood Stem Cell Transplantation, Thiotepa/administration & dosage
Pubmed
Open Access
Oui
Création de la notice
30/07/2008 10:23
Dernière modification de la notice
08/05/2019 17:56
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