Outcome of elderly patients with primary CNS lymphoma in the G-PCNSL-SG-1 trial
| Autor: | Eckhard Thiel, Stephan Kaun, Michael Weller, Alexander Röth, Robert Möhle, Michael Rauch, Philipp Kiewe, Patrick Roth, Agnieszka Korfel, H. A. Klasen, Peter Martus |
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| Přispěvatelé: | University of Zurich, Roth, P |
| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Lymphoma Antimetabolites medicine.medical_treatment Population Medizin Salvage therapy 610 Medicine & health Kaplan-Meier Estimate Gastroenterology Disease-Free Survival Central Nervous System Neoplasms Primary CNS Lymphoma Internal medicine medicine Confidence Intervals Humans In patient education Watchful Waiting Aged Response rate (survey) Salvage Therapy education.field_of_study Chemotherapy Leukopenia business.industry Age Factors Middle Aged Combined Modality Therapy Survival Analysis 10040 Clinic for Neurology Surgery 2728 Neurology (clinical) Methotrexate Toxicity Female Neurology (clinical) medicine.symptom Neoplasm Recurrence Local business |
| Popis: | To assess the outcome of elderly patients with primary CNS lymphoma (PCNSL) treated within the G-PCNSL-SG-1 trial.We reviewed response, toxicity, and survival of patients with PCNSL aged 70 or more enrolled in the G-PCNSL-SG-1 trial.A total of 126 of the 526 eligible patients (24%) and 66 of 318 patients (21%) in the per protocol population were aged 70 or more. Among all eligible patients, the rate of complete and partial responses (CR+PR) to HD-MTX-based chemotherapy was 44% in the elderly vs 57% in the younger patients (p = 0.016). Toxicity was age-independent except for a higher rate of grade III/IV leukopenia in the elderly (34% vs 21%, p = 0.007). Death on therapy was more frequent (18% vs 11%; p = 0.027), and progression-free survival (PFS) (4.0 vs 7.7 months, p = 0.014) and overall survival (12.5 vs 26.2 months, p0.001) inferior, in the elderly. A striking difference between younger and elderly patients was the PFS of CR patients of 35.0 in the younger vs 16.1 in the elderly patients (p = 0.024). Elderly patients were treated less often and less aggressively at salvage. However, age was not associated with survival from salvage whole brain radiotherapy in patients progressing during primary HD-MTX-based chemotherapy (p = 0.633).Lower response rate and higher mortality on HD-MTX-based chemotherapy as well as lower PFS of CR patients and less salvage therapy contribute to the poor prognosis of elderly patients with PCNSL. |
| Databáze: | OpenAIRE |
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