Published prospective trials in immunocompetent patients with PCNSL
No. . | TS* . | Primary chemotherapy† . | ORR, %‡ . | CRR, %§ . | Median follow-up, mo . | OS, % . | Neurotoxicity, % . | |||
---|---|---|---|---|---|---|---|---|---|---|
Drugs . | M dose . | it CHT . | 2 y . | 5 y . | ||||||
Chemotherapy alone | ||||||||||
31 | C | M | 8 g/m2/14 d | — | 100 | NR | 31 | 63 | NR | 0 |
25 | C | M | 8 g/m2/14 d | — | 74 | 52 | 23 | 70 | NR | 5 |
65 | C | M V I C A | 5 g/m2/28 d | ivM/a | 71 | 61 | 26 | 69 | 43 | 3 |
37 | C | M | 8 g/m2/14 d | — | 35 | 30 | 56 | 51 | 25 | 20 |
46 | C | M R Te–a E | 8 g/m2/14 d | — | NR | 63 | 40 | 71 | NR | 0 |
HD-MTX plus RT | ||||||||||
25 | CR | M | 3.5 g/m2/21 d | — | 88-92 | 56-88 | 60 | 58 | 38 | 8 |
46 | CR | M | 1 g/m2/7 d | a¶ | NR-95 | NR-82 | 36 | 62 | 37 | 22‖ |
31 | CRC | M | 1 g/m2/7 d | M | 64-87 | NR-87 | 97 | 72 | 22 | 32 |
HD-MTX-containing chemotherapy plus RT | ||||||||||
25 | CR | A a C M O P | 3 g/m2/21 d | M/a/P | 72-72 | 67-78 | 24 | 70 | 56 | 0 |
57 | CRC | aBnMO ± CHOP | 1.5-3 g/m2/14 d | — | 68-71 | 62-64 | 59 | 60 | 36 | NS |
56 | CR | Bn M N P | 1.5 g/m2/28 d | M | 71-100 | 54-61 | 8 | 86 | NS | 29 |
31 | CR | A B C M O P | 2 g/m2/15 d | M/a/P¶ | 89-67 | 24 | 48 | 36 | 7 | |
52 | CRC | M N O | 3.5 g/m2/7 d | M | 90-94 | 56-87 | 60 | 75 | 40 | 25 |
102 | CR | M N O | 2.5 g/m2/14 d | M | 94-NR | 58-NR | 56 | 64 | 32 | 15 |
52 | CR | Bn M O P | 3 g/m2/14 d | M | NR-81 | 33-69 | 27 | 69 | NR | 12 |
41 | CR | A I M T | 3.5 g/m2/21 d | — | 76-83 | 44-56 | 49 | 50 | 41 | NR |
30 | CRC | M N O R | 3.5 g/m2/14 d | M¶ | 93-NR | 44-77 | 37 | 67 | NR | NR |
99 | CR | AaCMO | 3 g/m2/21 d | M/P | 70-68 | 33-49 | 83 | 55 | 34 | 32 |
Randomized trials | ||||||||||
79 | CR | M | 3.5 g/m2/21 d | — | 40-40 | 18-30 | 30 | 39 | 26 | 20 |
M a | 3.5 g/m2/21 d | — | 69-74 | 46-64 | 56 | 46 | 6 | |||
551 | C ± R | M | 4 g/m2/14 d | — | 50 | 32 | ||||
M I | 3 g/m2/14 d | — | 65 | 42 |
No. . | TS* . | Primary chemotherapy† . | ORR, %‡ . | CRR, %§ . | Median follow-up, mo . | OS, % . | Neurotoxicity, % . | |||
---|---|---|---|---|---|---|---|---|---|---|
Drugs . | M dose . | it CHT . | 2 y . | 5 y . | ||||||
Chemotherapy alone | ||||||||||
31 | C | M | 8 g/m2/14 d | — | 100 | NR | 31 | 63 | NR | 0 |
25 | C | M | 8 g/m2/14 d | — | 74 | 52 | 23 | 70 | NR | 5 |
65 | C | M V I C A | 5 g/m2/28 d | ivM/a | 71 | 61 | 26 | 69 | 43 | 3 |
37 | C | M | 8 g/m2/14 d | — | 35 | 30 | 56 | 51 | 25 | 20 |
46 | C | M R Te–a E | 8 g/m2/14 d | — | NR | 63 | 40 | 71 | NR | 0 |
HD-MTX plus RT | ||||||||||
25 | CR | M | 3.5 g/m2/21 d | — | 88-92 | 56-88 | 60 | 58 | 38 | 8 |
46 | CR | M | 1 g/m2/7 d | a¶ | NR-95 | NR-82 | 36 | 62 | 37 | 22‖ |
31 | CRC | M | 1 g/m2/7 d | M | 64-87 | NR-87 | 97 | 72 | 22 | 32 |
HD-MTX-containing chemotherapy plus RT | ||||||||||
25 | CR | A a C M O P | 3 g/m2/21 d | M/a/P | 72-72 | 67-78 | 24 | 70 | 56 | 0 |
57 | CRC | aBnMO ± CHOP | 1.5-3 g/m2/14 d | — | 68-71 | 62-64 | 59 | 60 | 36 | NS |
56 | CR | Bn M N P | 1.5 g/m2/28 d | M | 71-100 | 54-61 | 8 | 86 | NS | 29 |
31 | CR | A B C M O P | 2 g/m2/15 d | M/a/P¶ | 89-67 | 24 | 48 | 36 | 7 | |
52 | CRC | M N O | 3.5 g/m2/7 d | M | 90-94 | 56-87 | 60 | 75 | 40 | 25 |
102 | CR | M N O | 2.5 g/m2/14 d | M | 94-NR | 58-NR | 56 | 64 | 32 | 15 |
52 | CR | Bn M O P | 3 g/m2/14 d | M | NR-81 | 33-69 | 27 | 69 | NR | 12 |
41 | CR | A I M T | 3.5 g/m2/21 d | — | 76-83 | 44-56 | 49 | 50 | 41 | NR |
30 | CRC | M N O R | 3.5 g/m2/14 d | M¶ | 93-NR | 44-77 | 37 | 67 | NR | NR |
99 | CR | AaCMO | 3 g/m2/21 d | M/P | 70-68 | 33-49 | 83 | 55 | 34 | 32 |
Randomized trials | ||||||||||
79 | CR | M | 3.5 g/m2/21 d | — | 40-40 | 18-30 | 30 | 39 | 26 | 20 |
M a | 3.5 g/m2/21 d | — | 69-74 | 46-64 | 56 | 46 | 6 | |||
551 | C ± R | M | 4 g/m2/14 d | — | 50 | 32 | ||||
M I | 3 g/m2/14 d | — | 65 | 42 |
Only trials on 25 patients or more and published as original articles are considered. Trials on high-dose chemotherapy supported by ASCT (Table 2) and focused on elderly patients (Table 3) are excluded. Updated from 40.
No. indicates number of enrolled patients; NS, not specified; and NR, not reported.
Treatment sequence: C indicates chemotherapy alone; CR, chemotherapy followed by radiotherapy; and CRC, chemotherapy followed by radiotherapy and further chemotherapy.
Primary chemotherapy: A or H, adriamycin; a, cytarabine; B, bleomycin; Bn, BCNU; C, cyclophosphamide; Cn, CCNU; E, etoposide; I, ifosfamide; M, methotrexate; N, procarbazine; O, vincristine; P, prednisone or other corticoids; R, rituximab; T, Thiotepa; Te, temozolomide; and V, teniposide.
ORR indicates overall response rate; in series treated with combined modality, response rate after chemotherapy and (—) after the entire planned treatment is reported.
CRR, Complete remission rate; in series treated with combined modality, response rate after chemotherapy and (—) after the entire planned treatment is reported.
Series using intrathecal chemotherapy (it CHT) exclusively in patients with positive CSF cytology at diagnosis.
Five-year risk rate.