Efficacy of Procarbazine, Lomustine, and Vincristine Chemotherapy for Recurrent Primary Central Nervous System Lymphomas.
10.14791/btrt.2015.3.2.75
- Author:
Young Joo KIM
1
;
Jai Ho CHOE
;
Jae Hyun PARK
;
Yong Kil HONG
Author Information
1. Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea. hongyk@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Lymphoma;
Central nervous system;
Salvage therapy;
Chemotherapy;
Methotrexate
- MeSH:
Central Nervous System*;
Consensus;
Disease-Free Survival;
Drug Therapy*;
Female;
Follow-Up Studies;
Hemorrhage;
Humans;
Lomustine*;
Lymphoma*;
Methotrexate;
Neutropenia;
Peripheral Nervous System Diseases;
Procarbazine*;
Recurrence;
Salvage Therapy;
Thrombocytopenia;
Vincristine*
- From:Brain Tumor Research and Treatment
2015;3(2):75-80
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Optimal treatment for recurrent primary central nervous system lymphomas (PCNSLs) has not been defined yet and there is no general consensus about the salvage chemotherapy after high-dose methotrexate (HD-MTX)-based chemotherapy. The purpose of the present study was to evaluate the efficacy and safety of procarbazine, lomustine, and vincristine (PCV) chemotherapy for recurrent PCNSLs. METHODS: We reviewed eight immunocompetent patients (five males/three females, mean age: 56 years) who received salvage PCV chemotherapy (procarbazine 60 mg/m2, days 8 through 21: CCNU 110 mg/m2, day 1: vincristine 2 mg, days 8 and 28) for recurrent PCNSL and two patients switched to PCV chemotherapy due to severe adverse effects of HD-MTX chemotherapy. Radiologic responses, survival, and adverse effects were analyzed. RESULTS: Of the eight recurrent PCNSLs, three patients (37.5%) showed radiologic complete response, one patient (12.5%) showed partial response, and four patients (50%) showed progressive disease after PCV chemotherapy. Median progression free survival (PFS) from the first administration of PCV to relapse or last follow-up was 7 months (range 5-32 months) and median overall survival was 8 months (range 2-41 months). The two patients who switched to PCV chemotherapy showed PFS of 9 and 5 months from the beginning of PCV to relapse. The common side effects were thrombocytopenia, neutropenia, and peripheral neuropathy. There were 4 grade III or IV myelo-suppression, but no fatal complications, including severe hemorrhage or infection, were observed. CONCLUSION: Salvage PCV chemotherapy has a moderate anti-lymphoma activity for recurrent PCNSLs after the HD-MTX-based chemotherapy with tolerable toxicity.
