PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA (PCNSL), RETROSPECTIVE ANALYSIS OF COMBINED CHEMO-RADIATION USING HIGH DOSE METHOTREXATE, EXPERIENCE FROM A SINGLE INSTITUTE

Introduction: Primary CNS lymphoma (PCNSL) is an aggressive primary brain tumor, cranial irradiation alone rarelyresult in long term disease control or prolonged survival. We analyzed our data for the impact of adding high dosemethotrexate (HDMTX) prior to whole brain irradiation (WBI).Materials and Methods: All patients with PCNSL diagnosed and managed during 20012004- were identified from Oncology Data Unit. Patient’s characteristics, prognostic factors, details of treatment and outcome were reviewed.Twenty-four patients were identified combined modality therapy included 34- cycles of HDMTX (3gm/m2) followed by WBI were given to all patients.Result: Median age was 39.2 years (range 1860-). Twenty nine percent (n=7) had ECOG performance status of greater than 2. There were 17 (70.8%) males and 7(29.2%) females with a male to female ratio of 2.4 to 1. Overall response rate (CR+PR) was 75%. Complete remission rate was 1145.8%) 24/) while partial response rate was 29.2% (724/).Median follow is 25.7 months (+/-19.1m); the median overall survival (OS) was 45 months (95% CI 14.589- months).Univariate analysis revealed that age and response had impact on OS and EFS, while only age was the only factor to have impact on survival in multivariate analysis.Conclusion: This retrospective study supports other phase II trials results that high dose methotrexate followed by WBIin PCNSL improves outcome.