Radiotherapy or Autologous Stem-Cell Transplantation for Primary CNS Lymphoma in Patients 60 Years of Age and Younger: Results of the Intergroup ANOCEF-GOELAMS Randomized Phase II PRECIS Study
| العنوان: | Radiotherapy or Autologous Stem-Cell Transplantation for Primary CNS Lymphoma in Patients 60 Years of Age and Younger: Results of the Intergroup ANOCEF-GOELAMS Randomized Phase II PRECIS Study |
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| المؤلفون: | Olivier Chinot, Khê Hoang-Xuan, Emmanuel Gyan, Luc Taillandier, Vincent Delwail, Thomas Gastinne, Thierry Lamy, Pierre Soubeyran, Jean-Marc Constans, Adrien Chauchet, Caroline Houillier, Nadine Martin-Duverneuil, Marie-Laure Tanguy, Mouna Laadhari, Reda Garidi, Damien Ricard, Antoine Martin, Alain Delmer, Isabelle Turbiez, Loïc Feuvret, P. Moisson, Intergroupe Goelams–Anocef, Antoine Thyss, Jérôme Cornillon, Marie-Pierre Moles, Nathalie Cassoux, Carole Soussain, A. Langer, Cécile Moluçon-Chabrot, Sylvain Choquet, Ahmad Al Jijakli, Remy Gressin, Julie Abraham, Lucette Lacomblez, Pierre Morel, Gandhi Damaj, Daniel Delgadillo, Valérie Touitou, Sylvain Dureau, Laurence Sanhes, Pascal Bourquard |
| المصدر: | Journal of Clinical Oncology. 37:823-833 |
| بيانات النشر: | American Society of Clinical Oncology (ASCO), 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, Oncology, Cancer Research, medicine.medical_specialty, Adolescent, Lymphoma, medicine.medical_treatment, Disease-Free Survival, law.invention, Central Nervous System Neoplasms, Young Adult, Autologous stem-cell transplantation, Randomized controlled trial, Chemoimmunotherapy, law, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, Humans, Medicine, Combined Modality Therapy, Young adult, Autografts, Febrile Neutropenia, business.industry, Alopecia, Induction Chemotherapy, Middle Aged, Clinical trial, Transplantation, Radiation therapy, Treatment Outcome, Female, business, Stem Cell Transplantation |
| الوصف: | PURPOSE To determine the efficacy and toxicity of chemoimmunotherapy followed by either whole-brain radiotherapy (WBRT) or intensive chemotherapy and autologous stem-cell transplantation (ASCT) as a first-line treatment of primary CNS lymphoma (PCNSL). PATIENTS AND METHODS Immunocompetent patients (18 to 60 years of age) with untreated PCNSL were randomly assigned to receive WBRT or ASCT as consolidation treatment after induction chemotherapy consisting of two cycles of R-MBVP (rituximab 375 mg/m2 day (D) 1, methotrexate 3 g/m2 D1; D15, VP16 100 mg/m2 D2, BCNU 100 mg/m2 D3, prednisone 60 mg/m2/d D1-D5) followed by two cycles of R-AraC (rituximab 375 mg/m2 D1, cytarabine 3 g/m2/D, D1, and D2). Intensive chemotherapy consisted of thiotepa (250 mg/m2/d D9; D8; D7), busulfan (8 mg/kg D6 through D4), and cyclophosphamide (60 mg/kg/d D3; D2). WBRT delivered 40 Gy (2 Gy/fraction). The primary end point was 2-year progression-free survival. Cognitive outcome was the main secondary end point. Analysis was intention to treat in a noncomparative phase II trial. RESULTS Between October 2008 and February 2014, 140 patients were recruited from 23 French centers. Both WBRT and ASCT met the predetermined threshold (among the first 38 patients in each group, at least 24 patients were alive and disease free at 2 years). The 2-year progression-free survival rates were 63% (95% CI, 49% to 81%) and 87% (95% CI, 77% to 98%) in the WBRT and ASCT arms, respectively. Toxicity deaths were recorded in one and five patients after WBRT and ASCT, respectively. Cognitive impairment was observed after WBRT, whereas cognitive functions were preserved or improved after ASCT. CONCLUSION WBRT and ASCT are effective consolidation treatments for patients with PCNSL who are 60 years of age and younger. The efficacy end points tended to favor the ASCT arm. The specific risk of each procedure should be considered. |
| تدمد: | 1527-7755 0732-183X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d45be99b2f2789b02412bbe515873576 https://doi.org/10.1200/jco.18.00306 |
| رقم الأكسشن: | edsair.doi.dedup.....d45be99b2f2789b02412bbe515873576 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15277755 0732183X |
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