CHOD/BVAM chemotherapy and whole-brain radiotherapy for newly diagnosed primary central nervous system lymphoma

Nadia N. Laack, Brian Patrick O'Neill, Karla V. Ballman, Judith Rich O'Fallon, Xiomara W. Carrero, Paul J. Kurtin, Bernd W. Scheithauer, Paul D. Brown, Thomas M. Habermann, Joseph P. Colgan, Mark R. Gilbert, Roland B. Hawkins, Roscoe F. Morton, Harry E. Windschitl, Tom R. Fitch, Eduardo R. Pajon

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Purpose: To assess the efficacy and toxicity of chemotherapy consisting of cyclophosphamide, doxorubicin (Adriamycin), vincristine, and dexamethasone (CHOD) plus bis-chloronitrosourea (BCNU), cytosine arabinoside, and methotrexate (BVAM) followed by whole-brain irradiation (WBRT) for patients with primary central nervous system lymphoma (PCNSL). Methods and Materials: Patients 70 years old and younger with newly diagnosed, biopsy-proven PCNSL received one cycle of CHOD followed by two cycles of BVAM. Patients then received WBRT, 30.6 Gy, if a complete response was evoked, or 50.4 Gy if the response was less than complete; both doses were given in 1.8-Gy daily fractions. The primary efficacy endpoint was 1-year survival. Results: Thirty-six patients (19 men, 17 women) enrolled between 1995 and 2000. Median age was 60.5 years (range, 34 to 69 years). Thirty (83%) patients had baseline Eastern Cooperative Oncology Group performance scores of 0 to 1. All 36 patients were eligible for survival and response evaluations. Median time to progression was 12.3 months, and median survival was 18.5 months. The percentages of patients alive at 1, 2, and 3 years were 64%, 36%, and 33%, respectively. The best response was complete response in 10 patients and immediate progression in 7 patients. Ten (28%) patients had at least one grade 3 or higher neurologic toxicity. Conclusions: This regimen did improve the survival of PCNSL patients but also caused substantial toxicity. The improvement in survival is less than that reported with high-dose methotrexate-based therapies.

Original languageEnglish (US)
Pages (from-to)476-482
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume81
Issue number2
DOIs
StatePublished - Oct 1 2011

Keywords

  • Chemotherapy
  • Primary central nervous system lymphoma
  • Whole-brain radiotherapy

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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    Laack, N. N., O'Neill, B. P., Ballman, K. V., O'Fallon, J. R., Carrero, X. W., Kurtin, P. J., Scheithauer, B. W., Brown, P. D., Habermann, T. M., Colgan, J. P., Gilbert, M. R., Hawkins, R. B., Morton, R. F., Windschitl, H. E., Fitch, T. R., & Pajon, E. R. (2011). CHOD/BVAM chemotherapy and whole-brain radiotherapy for newly diagnosed primary central nervous system lymphoma. International Journal of Radiation Oncology Biology Physics, 81(2), 476-482. https://doi.org/10.1016/j.ijrobp.2010.06.002