Kuitunen Hanne K, Rönkä Aino L K, Sonkajärvi Eila M, Isokangas Juha-Matti, Pyörälä Marja, Palosaari Kari A A, Jokimäki Anna S, Partanen Anu E, Littow Harri J, Vakkala Merja A, Jantunen Esa J, Huttunen Mirja E, Marin Katja J, Aromaa-Häyhä Annikki M K, Auvinen Päivi K, Selander Tuomas, Puhakka Inka K, Kuittinen Outi M
Cancer Center, Oulu University Hospital, 90220 Oulu, Finland.
Department of Oncology and Radiotherapy, Kuopio University Hospital, 70210 Kuopio, Finland.
Cancers (Basel). 2023 Feb 20;15(4):1341. doi: 10.3390/cancers15041341.
Primary central nervous system lymphoma is a rare but aggressive brain malignancy. It is associated with poor prognosis even with the current standard of care. The aim of this study was to evaluate the effect and tolerability of blood-brain barrier disruption treatment combined with high-dose treatment with autologous stem cell transplantation as consolidation on primary central nervous system lymphoma patients. We performed a prospective phase II study for 25 patients with previously untreated primary central nervous system lymphoma. The blood-brain barrier disruption treatment was initiated 3-4 weeks after the MATRix regimen using the previously optimized therapy protocol. Briefly, each chemotherapy cycle included two subsequent intra-arterial blood-brain barrier disruption treatments on days 1 and 2 via either one of the internal carotid arteries or vertebral arteries. Patients received the therapy in 3-week intervals. The treatment was continued for two more courses after achieving a maximal radiological response to the maximum of six courses. The complete treatment response was observed in 88.0% of the patients. At the median follow-up time of 30 months, median progression-free and overall survivals were not reached. The 2-year overall and progression-free survival rates were 67.1% and 70.3%, respectively. Blood-brain barrier disruption treatment is a promising option for primary central nervous system lymphoma with an acceptable toxicity profile.
原发性中枢神经系统淋巴瘤是一种罕见但侵袭性强的脑恶性肿瘤。即使采用当前的标准治疗方案，其预后仍较差。本研究的目的是评估血脑屏障破坏治疗联合高剂量自体干细胞移植巩固治疗对原发性中枢神经系统淋巴瘤患者的疗效和耐受性。我们对25例未经治疗的原发性中枢神经系统淋巴瘤患者进行了一项前瞻性II期研究。在使用先前优化的治疗方案完成MATRix方案3 - 4周后开始血脑屏障破坏治疗。简而言之，每个化疗周期在第1天和第2天通过颈内动脉或椎动脉之一进行两次连续的动脉内血脑屏障破坏治疗。患者每隔3周接受一次治疗。在达到最大放射学反应后继续治疗两个疗程，最多六个疗程。88.0%的患者观察到完全治疗反应。在中位随访时间30个月时，未达到中位无进展生存期和总生存期。2年总生存率和无进展生存率分别为67.1%和70.3%。血脑屏障破坏治疗对于原发性中枢神经系统淋巴瘤是一种有前景的选择，且毒性可接受。
