High-dose methotrexate combined with rituximab improves the survival rate of patients with primary central nervous system lymphoma.

PURPOSE

To explore the efficacy of high-dose methotrexate (HD-MTX) combined with rituximab (R) in the treatment of primary central nervous system lymphoma (PCNSL).

METHODS

108 PCNSL patients were randomly divided into Rituximab group (n=54) or control group (n=54). The patients in Rituximab group were treated with HD-MTX + R chemotherapy, while those in control group were given HD-MTX combined with whole brain radiotherapy (WBRT). The therapeutic effect, incidence rate of adverse reactions and the SF-36 score were compared between the two groups.

RESULTS

The overall response rate was overtly higher in Rituximab group than that in control group (81.5% vs. 57.4%). After treatment, the scores of physical function, physical competence, health condition, social function and emotional function in the SF-36 scale were notably higher in Rituximab group than those in control group. The 1-year overall survival (OS) rate was 83.3% (45/54) and 63.0% (34/54), 1-year progression-free survival (PFS) rate was 70.4% (38/54) and 46.3% (25/68), 3-year OS rate was 57.4% (31/54) and 31.5% (17/54), and 3-year PFS rate was 27.8% (15/54) and 14.8% (8/54) in Rituximab group and control group, respectively. The results of log-rank test showed that the OS and PFS rates in Rituximab group were obviously better than those in control group.

CONCLUSION

Compared with HD-MTX combined with WBRT, HD-MTX combined with R can remarkably improved the quality of life and survival rate of patients with PCNSL, with tolerable adverse reactions and is worthy of popularization and application in clinical practice.