P15.04 Treatment results of combination chemotherapy with high-dose methotrexate and procarbazine for primary CNS lymphoma: A single institution experience

摘要

BACKGROUND: This retrospective single-center study assessed the feasibility, outcomes, and side effects of high-dose methotrexate (HD-MTX) plus procarbazine in the treatment of immunocompetent patients with primary central nervous system lymphoma (PCNSL). METHODS: One-hundred twelve patients diagnosed with PCNSL between January 2001 and December 2014 were treated with HD-MTX (3.5 g/m²) plus procarbazine (60 mg/m²) To reduce neurotoxicity in patients aged ≥ 60 years, only those not responding to chemotherapy and patients with relapse underwent whole-brain irradiation. RESULTS: All 112 consecutive patients were scheduled to receive HD-MTX. Their median age was 67 years (range, 32-88 years) and their median Karnofsky performance score was 40 (range, 20-100). While 69 patients (61.6%) completed 3 cycles of HD-MTX chemotherapy and 60 (53.6%) showed a complete response, treatment was stopped in 14 patients (12.5%) due to toxicity. The median overall survival and progression-free survival were 51.1 and 7.6 months, respectively. Overall survival was significantly improved in patients who completed 3 cycles of chemotherapy compared with those did not (56.6 vs. 29.4 months; p = 0.03 by univariate- and p = 0.037 by multivariate analysis). >Conclusions: Initial treatment with HD-MTX plus procarbazine was effective in patients with PCNSL. ­Completion of 3 cycles of HD-MTX chemotherapy was a significant independent prognostic factor for patient survival.