Trial reportJournal of neuro-oncology2018
A prospective phase II trial of response adapted whole brain radiotherapy after high dose methotrexate based chemotherapy in patients with newly diagnosed primary central nervous system lymphoma-analysis of acute toxicity profile and early clinical outcome.
Trial report in Journal of neuro-oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses 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
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Pooled it
- High-dose methotrexate-based regimens and post-remission consolidation for treatment of newly diagnosed primary CNS lymphoma: meta-analysis of clinical trials.Scientific reports · 2021Pooled it
- The Efficacy and Safety of Cytarabine on Newly Diagnosed Primary Central Nervous System Lymphoma: A Systematic Review and Meta-Analysis.Frontiers in oncology · 2020Pooled it
- 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
- Prognostic factors and surgical approaches in the analysis of primary central nervous system diffuse large B-cell lymphoma: a large population-based cohort study and external validation.Frontiers in neurology · 2024Article
- Recent advances and challenges in primary central nervous system lymphoma: a narrative review.Translational cancer research · 2023Review
- [A single-center, retrospective analysis of relapse and progression patterns of primary central nervous system lymphoma: can whole brain radiotherapy be replaced?]Nan fang yi ke da xue xue bao = Journal of Southern Medical University · 2023Article
- The role of radiotherapy in newly diagnosed primary CNS lymphoma: A descriptive review and a pragmatic approach to clinical practice.Clinical and translational radiation oncology · 2023Review
- Article
- Reduced-dose WBRT as consolidation treatment for patients with primary CNS lymphoma: an LOC network study.Blood advances · 2022Article
- A Retrospective Analysis of R-MPV Plus Response-adapted Whole-brain Radiotherapy for Elderly Patients with Primary Central Nervous System Lymphoma.Internal medicine (Tokyo, Japan) · 2022Article
- Epidemiologic Characteristics, Prognostic Factors, and Treatment Outcomes in Primary Central Nervous System Lymphoma: A SEER-Based Study.Frontiers in oncology · 2022Article
- Role of 23.4 Gy upfront whole-brain radiation therapy following high-dose methotrexate for primary central nervous system lymphoma: a comparative analysis of whole-brain radiation therapy versus no radiation therapy.Journal of neuro-oncology · 2021Article
- Primary central nervous system lymphoma: a narrative review of ongoing clinical trials and goals for future studies.Annals of lymphoma · 2021Article
- Consolidation Therapy in Primary Central Nervous System Lymphoma.Current treatment options in oncology · 2020Review
- Management of Primary Central Nervous System Lymphoma Using Intra-Arterial Chemotherapy With Osmotic Blood-Brain Barrier Disruption: Retrospective Analysis of the Sherbrooke Cohort.Frontiers in oncology · 2020Article
- Primary CNS Lymphoma in India: A 17-Year Experience From the All India Institute of Medical Sciences.Journal of global oncology · 2019Article
- The importance of adequate methotrexate and adequate folinic acid rescue doses in the treatment of primary brain lymphoma.Journal of neuro-oncology · 2018Article
Corrections and comments
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Authors and funding
14 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe treatment of primary CNS lymphoma (PCNSL) comprises high dose methotrexate (HDMTX) based chemotherapy followed by whole brain radiotherapy (WBRT), the major drawback of which is long term neurotoxicity. We intended to assess the feasibility of response adapted WBRT in PCNSL in the Indian setting.
methodsWe screened 32 patients and enrolled 22 eligible patients with PCNSL from 2015 to 2017 in a prospective phase II trial. The patients underwent five 2-weekly cycles of induction chemotherapy with rituximab, methotrexate, vincristine, procarbazine. Patients with complete response(CR) to induction chemotherapy were given reduced dose WBRT 23.4 Gy/13 fractions/2.5 weeks while those with partial response (PR), stable or progressive disease (SD or PD) were given standard dose WBRT 45 Gy/25 fractions/5 weeks. Thereafter two cycles of consolidation chemotherapy with cytarabine were given. The primary endpoints of the study were assessment of response rate (RR) and progression free survival (PFS). The secondary endpoints of the study were assessment of overall survival (OS), toxicity profile of treatment and serial changes in quality of life and neuropsychological parameters.
resultsOut of 19 patients who completed HDMTX based chemotherapy, 10 (52.63%) patients achieved CR, 8 (42.11%) patients had PR and 1 patient had PD. After a median follow-up period of 11.25 months, the estimated median OS was 19 months. The actuarial rates of PFS and OS were respectively 94.1 and 68.2% at 1 year and 50.2 and 48.5% at 2 years. Three patients in reduced dose WBRT arm had recurrence and two of them died of progressive disease, whereas there was no recurrence or disease related death in standard dose WBRT arm. On univariate analysis of PFS, age ≤ 50 years and use of standard dose WBRT (45 Gy) led to significantly improved outcome (p value 0.03 and 0.02 respectively).
conclusionIn patients with PCNSL, reduced dose WBRT after CR to HDMTX based chemotherapy may lead to suboptimal clinical outcome due to higher risk of recurrence, progression and early death. Trial Registration No CTRI/2015/10/006268.
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