Different patterns of failure in two treatment regimens for primary central nervous system lymphoma, a retrospective analysis of 124 cases in Taiwan.

High dose methotrexate IELSG score MATRix regimen MSKCC score Primary CNS lymphoma

Journal

Clinical and experimental medicine
ISSN: 1591-9528
Titre abrégé: Clin Exp Med
Pays: Italy
ID NLM: 100973405

Informations de publication

Date de publication:
07 Sep 2023
Historique:
received: 18 06 2023
accepted: 28 08 2023
medline: 8 9 2023
pubmed: 8 9 2023
entrez: 7 9 2023
Statut: aheadofprint

Résumé

To explore prognostic factors and outcomes of primary central nervous system lymphoma (PCNSL) of diffuse large B-cell lymphoma (DLBCL) in Taiwan, 124 PCNSL-DLBCL patients (from 1995 to 2021) were retrospectively analyzed. Mainly, two treatment modalities including sandwich chemoradiotherapy and modified MATRix regimen were employed in these patients. Overall survival (OS) was determined by log-rank test and time-dependent Cox analysis. Median OS of all patients was 27.1 months. 47 (37.9%) patients who underwent sandwich chemoradiotherapy had a complete remission (CR) rate of 87.2%, median OS of 53.9 months, and progression free survival (PFS) of 42.9 months. 11 (8.9%) patients who underwent modified MATRix regimen had CR rate of 72.7%, median OS of 18.9, and PFS of 11.2 months. There are no significant OS differences between treatment groups or addition of Rituximab. Patients treated with the modified MATRix regimen experienced a higher early mortality rate followed by a survival plateau. IELSG low-risk group had significantly improved OS and PFS than IELSG intermediate- or high-risk group. In multivariant analysis, age > 60 years old and bilateral cerebral lesions are associated with significantly inferior OS. Sandwich chemoradiotherapy demonstrated better early survival and reduced treatment-related toxicity for PCNSL patients compared to the modified MATRix regimen. However, the long-term follow-up revealed a higher rate of treatment failure events in the sandwich chemoradiotherapy group. IELSG and MSKCC scores served as reliable risk assessment models. Incorporating bilateral cerebral lesions as a risk factor further improved risk evaluation.

Identifiants

DOI: 10.1007/s10238-023-01182-2 PMID: 37679606
pubmed: 37679606
doi: 10.1007/s10238-023-01182-2
pii: 10.1007/s10238-023-01182-2
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Chang Gung Memorial Hospital, Linkou
ID : CORPG3F0671
Organisme : Chang Gung Memorial Hospital, Linkou
ID : CMRPG3C1701

Informations de copyright

© 2023. The Author(s).

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Auteurs

Chin-Hsuan Chuang (CH)

Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing Street, Guishan Dist., Taoyuan City, 333423, Taiwan, ROC.

Ming-Chung Kuo (MC)

Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing Street, Guishan Dist., Taoyuan City, 333423, Taiwan, ROC.
College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Hung Chang (H)

Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing Street, Guishan Dist., Taoyuan City, 333423, Taiwan, ROC.
College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Jin-Hou Wu (JH)

Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing Street, Guishan Dist., Taoyuan City, 333423, Taiwan, ROC.

Yu-Shin Hung (YS)

Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing Street, Guishan Dist., Taoyuan City, 333423, Taiwan, ROC.

Che-Wei Ou (CW)

Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing Street, Guishan Dist., Taoyuan City, 333423, Taiwan, ROC.

Tung-Liang Lin (TL)

Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing Street, Guishan Dist., Taoyuan City, 333423, Taiwan, ROC.

Yi-Jiun Su (YJ)

Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing Street, Guishan Dist., Taoyuan City, 333423, Taiwan, ROC.

Yuen-Chin Ong (YC)

Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing Street, Guishan Dist., Taoyuan City, 333423, Taiwan, ROC.

Lee-Yung Shih (LY)

Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing Street, Guishan Dist., Taoyuan City, 333423, Taiwan, ROC.
College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Hsiao-Wen Kao (HW)

Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing Street, Guishan Dist., Taoyuan City, 333423, Taiwan, ROC. hsiaowen@cgmh.org.tw.
ORCID: 0000-0002-3586-5317

Classifications MeSH