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