Preirradiation methotrexate chemotherapy of primary central nervous system lymphoma: long-term outcome

✓ The treatment of primary central nervous system lymphoma with chemotherapy prior to whole-brain radiation therapy (WBRT) has improved outcome considerably in this previously fatal disease. Complete or partial responses to intravenous methotrexate (3.5 gm/sq m with leucovorin rescue every 3 weeks for two to four cycles) were seen in 12 of 13 patients originally treated. A total of 25 patients (including the original 13) have now been treated with one to six cycles of methotrexate every 10 to 21 days prior to WBRT. Twenty-two had partial or complete responses, with a median duration of response of 32 months. Median survival time was 33 months (42.5 months in those responding to therapy). Nine patients are alive and without evidence of disease 9 to 122 months following therapy. Acute and long-term toxicities were minimal. Systemic methotrexate administration prior to WBRT is well tolerated and produces long-term survival.

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Long-term survival in patients with newly diagnosed primary central nervous system lymphoma treated with dexamethasone, etoposide, ifosfamide and carboplatin chemotherapy and whole-brain radiation therapy

Leukemia & Lymphoma ◽

10.3109/10428194.2011.596967 ◽

2011 ◽

Vol 52 (11) ◽

pp. 2069-2075 ◽

Cited By ~ 15

Author(s):

Kazuya Motomura ◽

Atsushi Natsume ◽

Masazumi Fujii ◽

Motokazu Ito ◽

Hiroyuki Momota ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Radiation Therapy ◽

Central Nervous System Lymphoma ◽

Newly Diagnosed ◽

Term Survival ◽

Long Term Survival ◽

Whole Brain Radiation ◽

Brain Radiation

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Relapse rates and long-term outcome in primary angiitis of the central nervous system

Journal of Neurology ◽

10.1007/s00415-019-09285-1 ◽

2019 ◽

Vol 266 (6) ◽

pp. 1481-1489 ◽

Cited By ~ 1

Author(s):

Simon Schuster ◽

Ann-Kathrin Ozga ◽

Jan-Patrick Stellmann ◽

Milani Deb-Chatterji ◽

Vivien Häußler ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Term Outcome ◽

Long Term Outcome ◽

Primary Angiitis ◽

The Central Nervous System ◽

Relapse Rates

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International Primary Central Nervous System Lymphoma Collaborative Group (IPCG) Study on Low-Grade Primary Central Nervous System Lymphoma in Immunocompetent Patients.

Blood ◽

10.1182/blood.v106.11.3343.3343 ◽

2005 ◽

Vol 106 (11) ◽

pp. 3343-3343

Author(s):

Agnieszka Korfel ◽

Kristoph Jahnke ◽

Brian P. O’Neill ◽

Jean-Yves Blay ◽

Lauren Abrey ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Performance Status ◽

Eastern Cooperative Oncology Group ◽

Tumor Resection ◽

Central Nervous System Lymphoma ◽

Collaborative Group ◽

Low Grade ◽

Term Outcome ◽

Long Term Outcome

Abstract Low-grade primary central nervous system lymphoma is a very rare subtype of primary central nervous system lymphoma (PCNSL), for which almost no data is currently available. The purpose of this retrospective study was to characterize the clinical presentation, course and outcome of patients with low-grade PCNSL. Forty patients (18 male, 22 female) from 18 cancer centers in five countries were identified with a median age of 58 (range, 19–78) years and a median Eastern Cooperative Oncology Group (ECOG) performance status of 1 (range, 0–4). The mean time to diagnosis was 14.8 months (range, 0.25–84). Thirty-two patients (80%) had a B-cell and eight a T-cell lymphoma. Thirty-seven patients (92.5%) showed involvement of a cerebral hemisphere or deeper brain structures, while two evidenced only leptomeningeal involvement, and one patient had spinal cord disease. Treatment was performed in 39 patients: chemotherapy and radiotherapy in 15 (38%), radiotherapy alone in 12 (30%), chemotherapy alone in 10 (25%), and tumor resection alone in two. The median progression-free survival (PFS), disease-specific survival (DSS) and overall survival (OAS) were 61.5 (range, 0–204), 130 (range, 1–204), and 79 (range, 1–204) months, respectively. An age ≥60 years was associated with a shorter PFS (P = .009), DSS (P = .015) and OAS (P = .001) in multivariate analysis. Low-grade PCNSL differ from the high-grade subtype in pathological, clinical and radiological features. In this study, the long-term outcome was better as compared to the results obtained in PCNSL in general with age ≥60 years adversely affecting survival.

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Long-term outcome of hypothalamic/chiasmatic astrocytomas in children treated with conservative surgery

Journal of Neurosurgery ◽

10.3171/jns.1995.83.4.0583 ◽

1995 ◽

Vol 83 (4) ◽

pp. 583-589 ◽

Cited By ~ 94

Author(s):

Leslie N. Sutton ◽

Patricia T. Molloy ◽

Heidi Sernyak ◽

Joel Goldwein ◽

Peter L. Phillips ◽

...

Keyword(s):

Radical Surgery ◽

Conservative Surgery ◽

Low Grade ◽

Term Outcome ◽

Term Survival ◽

Long Term Outcome ◽

Content Type ◽

Fine Print

✓ The feasibility of radical surgery for astrocytomas of the optic chiasm/hypothalamus has been reported by several groups. Such surgery carries significant risks, however, including permanent damage to the pituitary gland, optic apparatus, hypothalamic structures, and carotid arteries. The benefits of radical surgery, both in terms of efficacy and toxicity, should, therefore, be evaluated against standard therapy, as is usually done for new chemotherapeutic protocols. To this end, a retrospective review was performed of 33 patients treated at Children's Hospital of Philadelphia between 1976 and 1991 who met criteria that would have made them eligible for radical surgery in many centers today, but were treated with either no surgery or conservative surgery (< 50% resection) or biopsy followed by adjuvant therapy with local radiation therapy (29 patients) and/or chemotherapy with actinomycin-D and vincristine (18 patients). The review encompassed all children with a globular enhancing mass of at least 2 cm in the hypothalamic/chiasmatic region, no evidence of optic nerve involvement or involvement of the optic radiations by computerized tomography or magnetic resonance imaging, and follow up of at least 3 years. All but one patient had tissue confirmation of a low-grade or pilocytic astrocytoma. Thirteen of the patients were 2 years of age or younger at diagnosis. Five individuals died: three of tumor progression, one of acute shunt malfunction, and one of intercurrent infection. The remaining 28 were alive at last follow up, a mean of 10.9 years from diagnosis. Twenty-three surviving patients have functional vision in at least one eye, 12 require no endocrine replacement, and 16 are in or have completed schooling with regular academic requirements. If radical surgery is to become standard care for children with low-grade astrocytomas of the hypothalamic/chiasmatic region, long-term survival and functional outcome will have to equal or surpass those of historical controls who were treated conservatively.

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Rehabilitation promotes functional movement in atypical populations

Behavioral and Brain Sciences ◽

10.1017/s0140525x00041649 ◽

1996 ◽

Vol 19 (1) ◽

pp. 82-83

Author(s):

Meg Morris ◽

Thomas Matyas ◽

Robert Iansek ◽

Ross Cunnington

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Motor Function ◽

Skill Learning ◽

Motor Skill Learning ◽

Term Outcome ◽

Functional Movement ◽

Long Term Outcome ◽

Cns Dysfunction

AbstractThe suggestion that movement disorders exhibited by people with central nervous system (CNS) dysfunction should be considered normal and therefore not rehabilitated is rejected from three standpoints: (1) the CNS does not always select the best movement patterns for optimal long term outcome, (2) there is literature demonstrating that rehabilitation enhances motor function and independence, and (3) there exists a capacity for motor recovery and motor skill learning following brain damage.

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