Chalise Lushun, Motomura Kazuya, Ohka Fumiharu, Hirano Masaki, Hara Masahito, Nishimura Yusuke, Natsume Atsushi, Wakabayashi Toshihiko
Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Japan.
Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Japan
Anticancer Res. 2017 Sep;37(9):5215-5223. doi: 10.21873/anticanres.11945.
BACKGROUND/AIM: In the current study, we aimed to compare DeVIC (dexamethasone, etoposide, ifosfamide and carboplatin) chemotherapy with high-dose methotrexate (HD-MTX) monotherapy plus whole-brain radiation therapy (WBRT) for newly-diagnosed primary central nervous system lymphoma (PCNSL), in terms of their efficacies and tolerability.
A total of 21 consecutive patients with PCNSL were treated with DeVIC therapy and WBRT, between 2002 and 2010. From 2010 to 2014, 14 consecutive patients with PCNSL were treated with HD-MTX followed by WBRT.
Overall response rates of complete and partial response for initial chemotherapy were significantly better with DeVIC therapy (95.2%) than with HD-MTX monotherapy (50%). Furthermore, one-year and two-year progression-free survival (PFS) rates were better in the DeVIC cohort than in the HD-MTX cohort. DeVIC therapy yielded higher early response rates, longer PFS, and manageable adverse events, and may be potentially better for the treatment of cases that are refractory to MTX-based therapy.
Our retrospective clinical study revealed that DeVIC therapy is comparable with that of HD-MTX monotherapy plus WBRT, for newly diagnosed PCNSL.
背景/目的：在本研究中，我们旨在比较地塞米松、依托泊苷、异环磷酰胺和卡铂（DeVIC）化疗与高剂量甲氨蝶呤（HD-MTX）单药治疗加全脑放射治疗（WBRT）对新诊断的原发性中枢神经系统淋巴瘤（PCNSL）的疗效和耐受性。
2002年至2010年期间，共有21例连续的PCNSL患者接受了DeVIC治疗和WBRT。2010年至2014年期间，14例连续的PCNSL患者接受了HD-MTX治疗，随后进行WBRT。
初始化疗的完全缓解和部分缓解的总体缓解率，DeVIC治疗（95.2%）显著优于HD-MTX单药治疗（50%）。此外，DeVIC队列的1年和2年无进展生存率（PFS）高于HD-MTX队列。DeVIC治疗产生了更高的早期缓解率、更长的PFS以及可控制的不良事件，对于对基于MTX的治疗难治的病例可能具有潜在的更好疗效。
我们的回顾性临床研究表明，对于新诊断的PCNSL，DeVIC治疗与HD-MTX单药治疗加WBRT相当。
