AI Article Synopsis

  • Primary central nervous system lymphoma (PCNSL) is a brain tumor that constitutes roughly 4.6% of all primary brain tumors, typically treated with high-dose methotrexate chemotherapy and whole-brain irradiation, but no established salvage therapies exist for those who don’t respond to initial treatment.
  • The study involved administering ESHAP therapy as a secondary treatment for patients with refractory or recurrent PCNSL, with evaluations focused on performance status and overall survival, using established response criteria.
  • Results showed a significant response rate of 77.8% after the first ESHAP treatment, with 66.7% of patients experiencing grade 3 or higher adverse events, all of which were manageable, indicating a promising potential

Article Abstract

Background: Primary central nervous system lymphoma(PCNSL)is a primary brain tumor, which appears commonly and occupies around 4.6% of all primary brain tumors. The standard therapy for this tumor is high-dose methotrexate chemotherapy(HD-MTX)and whole-brain irradiation. No salvage therapies for HD-MTX therapy-refractory or recurrent PCNSLs have been standardized. In our institution, ESHAP therapy(high-dose cytarabine:2,000mg, cisplatin:25mg/m, etoposide:40mg/m, methylprednisolone:500mg)was administered as a secondary chemotherapy, and the efficiency was examined.

Methods: We administered ESHAP therapy as secondary chemotherapy for patients with refractory/recurrent PCNSL after HD-MTX therapy. Patients with PCNSL who were diagnosed and treated at our institute since 1996 were retrospectively studied. Clinical evaluations were performed based on Karnofsky Performance Status and overall survival, and the effect of ESHAP therapy was evaluated using the Response Assessment in Neuro-Oncology criteria.

Results: The number of patients with refractory/recurrent PCNSLs were 18(28-77 years of age, median age of 58.5 years). The response rate(RR)after the first course of salvage ESHAP therapy was 77.8%(14 cases), and complete response(CR)was achieved in 6 cases. The RR after the final course of ESHAP therapy was as high as 61.1%(11 cases), and 4 patients retained CR status. In patients with refractory PCNSL who were treated with HD-MTX, the RR in the final course of salvage ESHAP therapy was as high as 77.8%(7 cases), and 3 patients retained CR status during the periods. The occurrence rate of Grade 3 or higher adverse events, according to the Common Terminology Criteria for Adverse Events version 4.0, was 66.7%(12 cases);all events that were associated with blood and lymphatic system disorders were quickly alleviated, and no fatal adverse events occurred.

Conclusion: In this study, we retrospectively examined the efficacy of ESHAP therapy as a secondary chemotherapy for patients with refractory/recurrent PCNSL after receiving HD-MTX therapy. Based on our findings, we suggest that ESHAP therapy should be considered as an encouraging secondary chemotherapy for patients with refractory/recurrent PCNSL.

Download full-text PDF

Source
http://dx.doi.org/10.11477/mf.1436203773DOI Listing

Publication Analysis

Top Keywords

eshap therapy
28
secondary chemotherapy
16
patients refractory/recurrent
16
salvage eshap
12
chemotherapy patients
12
refractory/recurrent pcnsl
12
adverse events
12
therapy
10
eshap
9
primary brain
8

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!