Maintenance of multi-domain neurocognitive functions in patients with newly-diagnosed primary CNS lymphoma after primary cranial radiotherapy combined with methotrexate-based chemotherapy: A preliminary case-series study

Lin, Shinn‐Yn; Chuang, Chi‐Cheng; Tsan, Din-Li; Hung, Yu‐Shin; Fu, Chen-Ju; Shen, Yeh-You; Chiang, Yin-Yin; Huang, Yin-Cheng; Lu, Yu-Jen; Yang, Chi‐Cheng

doi:10.1080/23279095.2020.1749630

Cited by 3 publications

(1 citation statement)

References 23 publications

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“…Radiotherapy has been used for decades as the treatment of PCNSL, but its role has been diminishing recently. Clinical data has shown that can lead to serious neurotoxicity, such as cognition, memory and other functions impairment, brain atrophy, leukoencephalopathy, endocrine disorders and even dementia [ 18 , 19 , 20 ]. A growing number of clinical trials have shown the efficacy of several treatment strategies, but high-dose methotrexate still represents a milestone in the chemotherapy on PCNSL because of it crosses the blood-brain barrier (BBB).…”

Section: Discussionmentioning

confidence: 99%

Ibrutinib Monotherapy as Bridge-to-Transplant for Relapsed/Refractory Primary Oculo-Cerebral Lymphoma

Deak-Mihaly

Iluta

Pașca

et al. 2021

JCM

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Introduction. Primary central nervous system lymphoma is an uncommon form of extranodal non-Hodgkin’s lymphoma, with increasing incidence, a relatively aggressive course and a poor 5-year survival. Because of its localization, the therapeutic compounds used in this disease must be able to pass through the blood-brain barrier. Chemotherapy regimens based on high-dose methotrexate are currently the standard of care for all patients who can tolerate such drugs. Autologous stem cell transplantation is indicated for malignant lymphomas in the relapsed/refractory setting. Methods. Three patients, with a median age of 60 years, range 53–64, were diagnosed with primary CNS lymphoma, and treated with ibrutinib monotherapy in the Department of Hematology, Ion Chiricuta Clinical Cancer Center, Cluj-Napoca, Romania, between September 2018 and November 2020 All the patients were relapsed–refractory following high-dose methotrexate chemotherapy. We present our experience using ibrutinib monotherapy-based treatment as a bridge-to-transplant option on a single-center case series and a review of the literature in this field. Results. Two of the patients were given ibrutinib as a second line therapy, both achieving complete remission and being eligible for an autologous stem cell transplantation. The third patient achieved a short remission using six cycles of systemic chemotherapy, but was started on ibrutinib monotherapy, with limited results. Conclusion. Our data is limited, and these results should be confirmed by multicentric clinical trials and should be regarded as a single-center case series, with all its limitations. Still, it brings forward a new therapeutic option for this rare subtype of malignant lymphomas, which if left untreated has a dismal prognosis.

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Section: Discussionmentioning

confidence: 99%

Ibrutinib Monotherapy as Bridge-to-Transplant for Relapsed/Refractory Primary Oculo-Cerebral Lymphoma

Deak-Mihaly

Iluta

Pașca

et al. 2021

JCM

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Neuropsychological performances in patients with infiltrative non-GBM gliomas after postoperative adjuvant photon or proton radiotherapy: A prospective and preliminary investigation

Lin

Chuang

Huang

et al. 2022

Applied Neuropsychology: Adult

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The Impact of Tumor Resection on Survival and Functional Outcomes for Patients with Primary Central Nervous System Lymphoma

Nien,

Chuang,

Hsu

et al. 2024

Preprint

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Purpose The role of tumor resection remains undetermined in treating primary central nervous system lymphomas (PCNSLs). This study aimed to clarify the impact of tumor resection on survival and functional outcomes, and to identify subgroups benefiting from resection. Methods We retrospectively reviewed records from 2010 to 2021 for PCNSL diagnosed at Chang Gung Memorial Hospital, Linkou. Patients were categorized by extent of resection: gross total resection (GTR), partial resection (PR), and biopsy. Univariate and multivariate analyses were performed to identify prognostic factors for survival and functional outcomes. Subgroup analysis was conducted to characterize patients who benefit from tumor resection. Results Of 88 patients, 12 had GTR, 25 had PR, and 51 received biopsy. GTR correlated with longer progression free survival (PFS) (HR 0.25, p = 0.039), remaining significant in multivariate analysis (adjusted HR 0.09, p = 0.004). In solitary PCNSLs, GTR also independently predicted longer PFS (adjusted HR 0.13, p = 0.023). Patients with dominant tumors measuring ≥ 3cm trended towards improved overall survival (OS) with cytoreductive surgery versus biopsy (median survival 38.6 months vs 22.3 months, p = 0.083). Age ≥ 60 years (adjusted OR 16.9, p = 0.008) and preoperative Karnofsky Performance Scale ≤ 70 (adjusted OR 4.97, p = 0.049) predicted poorer functional outcomes, while radiation therapy (adjusted OR 0.10, p = 0.033) was protective. Conclusions GTR significantly improved PFS in treating PCNSLs, particularly in solitary cases. For patients with dominant tumors measuring ≥ 3cm, cytoreductive surgery may improve OS. Neither cytoreductive surgery nor GTR correlated with poor functional outcomes.

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Maintenance of multi-domain neurocognitive functions in patients with newly-diagnosed primary CNS lymphoma after primary cranial radiotherapy combined with methotrexate-based chemotherapy: A preliminary case-series study

Cited by 3 publications

References 23 publications

Ibrutinib Monotherapy as Bridge-to-Transplant for Relapsed/Refractory Primary Oculo-Cerebral Lymphoma

Ibrutinib Monotherapy as Bridge-to-Transplant for Relapsed/Refractory Primary Oculo-Cerebral Lymphoma

Neuropsychological performances in patients with infiltrative non-GBM gliomas after postoperative adjuvant photon or proton radiotherapy: A prospective and preliminary investigation

The Impact of Tumor Resection on Survival and Functional Outcomes for Patients with Primary Central Nervous System Lymphoma

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