Long‐term outcomes of frontline intensification in primary CNS lymphoma: A real‐world single‐center experience

Background Frontline intensification (including consolidative whole‐brain radiotherapy or high‐dose chemotherapy with autologous stem‐cell transplantation after induction therapy) has been proposed to treat primary central nervous system lymphoma (PCNSL). However, no prospective randomized trials ha...

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Published in:Cancer medicine (Malden, MA) MA), 2023-04, Vol.12 (7), p.8089-8101
Main Authors: Wang, Hao‐Yuan, Yang, Ching‐Fen, Lin, Chia‐Hsin, Hsiao, Liang‐Tsai, Ko, Po‐Shen, Liu, Yao‐Chung, Chiou, Tzeon‐Jye, Chen, Po‐Min, Gau, Jyh‐Pyng, Liu, Jin‐Hwang, Liu, Chia‐Jen
Format: Article
Language:English
Subjects:
Adult
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Cancer therapies
Central nervous system
Central Nervous System Neoplasms
Chemotherapy
Clinical trials
Combined Modality Therapy
frontline consolidation
frontline intensification
Hematopoietic Stem Cell Transplantation
HIV
Human immunodeficiency virus
Humans
Induction therapy
Lymphoma
Medical prognosis
Mortality
Nervous system
non‐Hodgkin's lymphoma
Palliative care
Patients
primary CNS lymphoma
Radiation therapy
Remission (Medicine)
Retrospective Studies
Stem cell transplantation
Transplantation, Autologous
Transplants & implants
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Summary:Background Frontline intensification (including consolidative whole‐brain radiotherapy or high‐dose chemotherapy with autologous stem‐cell transplantation after induction therapy) has been proposed to treat primary central nervous system lymphoma (PCNSL). However, no prospective randomized trials have answered whether frontline intensification can offer a survival benefit to PCNSL patients. We aim to clarify the outcomes and survival influence of frontline intensification on real‐world patients with different risk‐stratified PCNSLs. Methods Between January 2003 and December 2016, 110 PCNSL adults were retrospectively included, and 76 patients achieved at least PR after induction therapy, including 38 patients who received frontline intensification. The median follow‐up with the 31 survivors was 7.52 years. Results Of the 38 induction‐completed patients who had not received frontline intensification, 95% achieved post–induction therapy CR/CRu; however, all inevitably recurred. In the 38 who received frontline intensification, CR/CRu improved from 45% (pre‐frontline intensification) to 84% (post‐frontline intensification), and they achieved significantly better PFS (non‐reach vs. 522 days, p 
ISSN:2045-7634
2045-7634
DOI:10.1002/cam4.5607