Efficacy and safety of the R2-MTX regimen in primary central nervous system lymphoma (PCNSL): a single-center retrospective analysis.

IF 2.7 3区 医学 Q3 ONCOLOGY
Lijie Liang, Xue Meng, Li Xie, Na Li, You Feng, Ming Jiang
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Abstract

Purpose: Primary central nervous system lymphoma (PCNSL) has a poor prognosis, mainly because of the significant challenges with the efficacy and tolerability of induction chemotherapy. This retrospective study aimed to evaluate the efficacy and safety of the R2-MTX regimen in PCNSL patients.

Methods: We conducted a retrospective analysis of 39 PCNSL patients treated with the R2-MTX regimen, focusing on treatment outcomes and adverse events (AEs).

Results: The overall response rate (ORR) was 72.2%, with a complete response (CR) rate of 69.4% and a partial response (PR) rate of 2.8%. With a median follow-up of 37.2 months (interquartile range [IQR] 24.2-47.5), the estimated 2-year progression-free survival (PFS) and overall survival (OS) rates were 54.9% (95% CI, 37.2-69.5%) and 78.5% (95% CI, 59.8-89.2%), respectively. The most common grade 3 or 4 AEs included neutropenia (33.3%), leukopenia (13.9%), anemia (2.8%), and thrombocytopenia (2.8%). Consolidation or maintenance therapy was associated with prolonged survival in PCNSL patients (2-year OS rates 100% vs. 42.9%, P = 0.067). Survival analysis revealed that clinicopathological factors, such as double-expressor lymphoma (DEL), ECOG PS ≥ 2, and high-risk classification based on the Memorial Sloan Kettering Cancer Center model (MSKCC), predicted poor survival.

Conclusions: Our results underscore the therapeutic potential of the R2-MTX regimen in managing newly diagnosed PCNSL patients. Further prospective studies with larger patient cohorts are imperative to solidify these preliminary findings.

R2-MTX方案治疗原发性中枢神经系统淋巴瘤(PCNSL)的疗效和安全性:一项单中心回顾性分析
目的:原发性中枢神经系统淋巴瘤(Primary central nervous system lymphoma, PCNSL)预后较差,主要原因是诱导化疗的疗效和耐受性存在较大挑战。本回顾性研究旨在评估R2-MTX方案在PCNSL患者中的有效性和安全性。方法:我们对39例接受R2-MTX方案治疗的PCNSL患者进行回顾性分析,重点关注治疗结果和不良事件(ae)。结果:总缓解率(ORR)为72.2%,完全缓解率(CR)为69.4%,部分缓解率(PR)为2.8%。中位随访37.2个月(四分位间距[IQR] 24.2-47.5),估计2年无进展生存(PFS)和总生存(OS)率分别为54.9% (95% CI, 37.2-69.5%)和78.5% (95% CI, 59.8-89.2%)。最常见的3或4级ae包括中性粒细胞减少症(33.3%)、白细胞减少症(13.9%)、贫血(2.8%)和血小板减少症(2.8%)。巩固或维持治疗与PCNSL患者的延长生存相关(2年OS率为100% vs. 42.9%, P = 0.067)。生存分析显示,临床病理因素,如双表达性淋巴瘤(DEL), ECOG PS≥2,以及基于纪念斯隆-凯特琳癌症中心模型(MSKCC)的高风险分类,预测了较差的生存。结论:我们的研究结果强调了R2-MTX方案在治疗新诊断的PCNSL患者中的治疗潜力。进一步的前瞻性研究需要更大的患者队列来巩固这些初步发现。
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来源期刊
CiteScore
4.00
自引率
2.80%
发文量
577
审稿时长
2 months
期刊介绍: The "Journal of Cancer Research and Clinical Oncology" publishes significant and up-to-date articles within the fields of experimental and clinical oncology. The journal, which is chiefly devoted to Original papers, also includes Reviews as well as Editorials and Guest editorials on current, controversial topics. The section Letters to the editors provides a forum for a rapid exchange of comments and information concerning previously published papers and topics of current interest. Meeting reports provide current information on the latest results presented at important congresses. The following fields are covered: carcinogenesis - etiology, mechanisms; molecular biology; recent developments in tumor therapy; general diagnosis; laboratory diagnosis; diagnostic and experimental pathology; oncologic surgery; and epidemiology.
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