Ekenel M et al. - Consolidation treatment with whole-brain radiation therapy (WBRT), high-dose cytarabine (HDAC), or both does not appear to improve survival in patients who achieved a complete response (CR) with induction MTX-based therapy. Age, Karnofsky performance scale (KPS), and risk of delayed neurotoxicity must be considered in the choice of consolidation regimens. Methods
A retrospective study to assess the impact of consolidation treatment after a CR to initial induction chemotherapy on disease control and survival
122 pts who achieved a CR after initial MTX-based chemotherapy were analyzed
The benefit of consolidation WBRT, HDAC or both on failure-free (FFS) and overall survival (OS) was assessed
Results
Median f/u of 60 mos; FFS was longer in pts who received WBRT plus HDAC as consolidation treatment
No difference in OS among pts who received no consolidation treatment, HDAC alone, WBRT plus HDAC, or WBRT alone
Age and KPS were the only independent prognostic factors
Pts who received WBRT alone or in combination with HDAC had higher rates of neurotoxicity
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