原发性中枢神经系统淋巴瘤
医学
替莫唑胺
丙卡巴嗪
长春新碱
内科学
耐受性
肿瘤科
美罗华
维持疗法
甲氨蝶呤
放射治疗
化疗
毒性
外科
淋巴瘤
环磷酰胺
不利影响
作者
Géraldine Faivre,Matthew J. Butler,Isabelle Le,Andrew Brenner
标识
DOI:10.1016/j.clml.2019.05.012
摘要
Optimal management of elderly patients with primary central nervous system lymphoma (PCNSL) after induction therapy is unclear. Whole-brain radiotherapy and autologous stem cell transplantation carry increased toxicity in patients older than 60 years of age, which might outweigh the benefits in this group. Temozolomide (TMZ) has established antineoplastic activity in the central nervous system in other disease states, with a favorable toxicity profile.We report efficacy and tolerability in a series of 10 patients treated off-label with TMZ maintenance after completion of R-MPV (rituximab, methotrexate, procarbazine and vincristine) treatment for or primary diagnosed PCNSL.Median progression-free survival (PFS) was 57 months, 2-year PFS was 67%, and 5-year PFS was 33%. Median overall survival (OS) was 63 months, 2-year OS was 88%, and 5-year OS was 57%. TMZ was generally well tolerated, with the most common toxicity of Grade 3 or higher being thrombocytopenia in 3 patients (30%).These outcomes suggest that TMZ might have activity for maintenance in elderly patients with PCNSL, when more aggressive treatments are contraindicated.
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