SynthesisAnnals of oncology : official journal of the European Society for Medical Oncology2015
First-line treatment and outcome of elderly patients with primary central nervous system lymphoma (PCNSL)--a systematic review and individual patient data meta-analysis.
Synthesis in Annals of oncology : official journal of the European Society for Medical Oncology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
91 citing papers in PubMed, 1 synthesis or guideline pooled it, 188 citations in OpenAlex.
- Primary pituitary lymphoma: an update of the literature.Journal of neuro-oncology · 2016Pooled it
- Sintilimab (anti-PD-1 antibody) combined with high-dose methotrexate, temozolomide, and rituximab (anti-CD20 antibody) in primary central nervous system lymphoma: a phase 2 study.Signal transduction and targeted therapy · 2024Trial
- Safety and efficacy of tisagenlecleucel in primary CNS lymphoma: a phase 1/2 clinical trial.Blood · 2022Trial
- Impact of contemporary regimens on the outcomes and toxicity of primary CNS lymphoma: a single-center retrospective analysis of 73 patients.Journal of neuro-oncology · 2021Trial
- High-dose methotrexate-based immuno-chemotherapy for elderly primary CNS lymphoma patients (PRIMAIN study).Leukemia · 2017Trial
- Primary central nervous system lymphoma-current standards and recent developments.Neuro-oncology practice · 2026Review
- Primary central nervous system lymphoma in the molecular era: genomic drivers, liquid biopsy, and targeted therapeutic strategies.Annals of hematology · 2026Review
- Intensified Rituximab, Methotrexate, Procarbazine, and Cytarabine (R-MPVA) Regimen With Sequential Addition of Etoposide to R-MPV and Ifosfamide to R-AraC for Newly Diagnosed Primary CNS Lymphoma Patients Aged Between 60 and 70 Years: An LOC Network Study.Hematological oncology · 2026Article
- Unraveling the immune microenvironment in primary CNS lymphoma.Biomarker research · 2026Review
- Consolidation reduced-dose whole-brain radiation therapy with response-adapted boost in older patients with newly diagnosed primary central nervous system lymphoma.Journal of neuro-oncology · 2026Article
- Translating advances in primary central nervous system lymphoma: from prognostic stratification to treatment innovation.Frontiers in oncology · 2026Review
- Importance of radiation-related cognitive decline in older adults who receive cranial radiation.Expert review of anticancer therapy · 2025Review
- Article
- Role of Radiotherapy in PCNSL within the Current Therapeutic Landscape: a Comprehensive Review.Current treatment options in oncology · 2025Review
- Article
- Efficacy and safety of the R2-MTX regimen in primary central nervous system lymphoma (PCNSL): a single-center retrospective analysis.Journal of cancer research and clinical oncology · 2025Article
- Association between surgery and increased survival in primary central nervous system lymphoma: a retrospective cohort study.Scientific reports · 2025Article
- Clinical Characteristics, Prognostic Risk Factors, and Primary Treatment for Elderly Patients with Primary Central Nervous System Lymphoma: A Seer Database-Based Research.Blood and lymphatic cancer : targets and therapy · 2025Article
- Novel Therapies for Primary Central Nervous System Lymphomas.Current neurology and neuroscience reports · 2024Review
- A case report of surgery-radiotherapy-chemotherapy cured primary diffuse large B-cell lymphoma of the central nervous system associated with HIV infection.Diagnostic pathology · 2024Article
31 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
25 authors at 14 institutions in 10 countries.
Funding
Abstract
backgroundTo investigate prognosis and effects of first-line therapy in elderly primary central nervous system lymphoma (PCNSL) patients. PATIENTS AND
methodsA systematic review of studies about first-line therapy in immunocompetent patients ≥60 years with PCNSL until 2014 and a meta-analysis of individual patient data from eligible studies and international collaborators were carried out.
resultsWe identified 20 eligible studies; from 13 studies, we obtained individual data of 405 patients, which were pooled with data of 378 additional patients (N = 783). Median age and Karnofsky Performance Score (KPS) was 68 years (range: 60-90 years) and 60% (range: 10%-100%), respectively. Treatments varied greatly, 573 (73%) patients received high-dose methotrexate (HD-MTX)-based therapy. A total of 276 patients received whole-brain radiotherapy (median 36 Gy, range 28.5-70 Gy). KPS ≥ 70% was the strongest prognostic factor for mortality [hazard ratio (HR) 0.50, 95% confidence interval (CI) 0.41-0.62]. After a median follow-up of 40 months, HD-MTX-based therapy was associated with improved survival (HR 0.70, 95% CI 0.53-0.93). There was no difference between HD-MTX plus oral chemotherapy and more aggressive HD-MTX-based therapies (HR 1.39, 95% CI 0.90-2.15). Radiotherapy was associated with an improved survival, but correlated with an increased risk for neurological side-effects (odds ratio 5.23, 95% CI 2.33-11.74).
conclusionsElderly PCNSL patients benefit from HD-MTX-based therapy, especially if combined with oral alkylating agents. More aggressive HD-MTX protocols do not seem to improve outcome. WBRT may improve outcome, but is associated with increased risk for neurological side-effects. Prospective trials for elderly PCNSL patients are warranted.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.