scholarly journals Primary Central Nervous System Lymphoma (PCNSL): Analysis of Treatment by Gamma Knife Radiosurgery and Chemotherapy in a Prospective, Observational Study

Cureus ◽  
2016 ◽  
Author(s):  
Andres M Alvarez-Pinzon ◽  
Aizik L Wolf ◽  
Heather Swedberg ◽  
Sammie R Coy ◽  
Jose E Valerio
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Observational Study ◽  
Gamma Knife ◽  
Prospective Observational Study ◽  
Gamma Knife Radiosurgery ◽  
Central Nervous System Lymphoma

scholarly journals Efficacy and Safety of Pemetrexed Combined with Lenalidomide in the Treatment of Relapsed/Refractory Primary Central Nervous System Lymphoma

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 2-3
Author(s):  
Jingjing Ma ◽  
Bobin Chen ◽  
Lin Zhiguang ◽  
Qing Li ◽  
Hui Kang ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Adverse Events ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Conflicts Of Interest ◽  
Central Nervous System Lymphoma ◽  
Ventricular Premature Beat ◽  
Efficacy And Safety ◽  
Grade 3

ABSTRACT BACKGROUND/PURPOSE: There is currently no standard effective treatment for patients with relapsed/refractory primary central nervous system lymphoma (PCNSL). The prognosis is poor, so more studies are needed. Pemetrexed is similar to methotrexate in structure and can cross the blood-brain barrier. Compared with methotrexate, it has more targets and fewer side effects. Lenalidomide is a second generation immunomodulator with multiple functions, such as regulating immunity, anti-tumor and tumor microenvironment. A prospective observational study was conducted to explore the efficacy and safety of pemetrexed combined with lenalidomide in the treatment of relapsed/refractory primary central nervous system lymphoma. METHODS: This is a prospective observational study, we collected patients who had undergone whole brain radiotherapy and two or more chemotherapy regimens between January 2018 and December 2019 but still experienced disease progression or recurrence. each patient was treated with pemetrexed at a dose of 900mg/m2 and lenalidomide 25mg over 3 weeks as salvage chemotherapy, and one cycle consists of 4 weeks. Folic acid, vitamin B12 and dexamethasone were used to induce toxicities to pemetrexed given before chemotherapy. Oral aspirin was used to prevent thrombosis caused by lenalidomide. Adverse events were recorded in each patient during inpatients, outpatient or telephone follow-up. RESULTS: A total of 38 patients with recurrent/refractory PCNSL were enrolled in our study, including 26 males and 12 females with a median age of 57 (range from 33 to 73) years old. After treatment, the overall response rate was 68.4%(Table 1). The median progression free survival (PFS) time was 6 months and median overall survival (OS) time was 14 months (Figure1, Figure2). The adverse events mainly included fatigue, gastrointestinal reaction, myelosuppression, thrombocytopenia, fever and infection. After long-term or short-term chemotherapy, the patients had different degrees of myelosuppression symptoms presented as leukopenia (six cases in grade 1 and one case in grade 3), neutropenia (six cases in grade 1 and two cases in grade 3), anemia (6 cases in grade 1), thrombocytopenia (1 case in grade 2 and 3 cases in grade 3). Nausea and vomiting, as the common gastrointestinal reaction, appeared in two (grade 1) and one (grade 2) cases, respectively. One patient died of severe pneumonia infection. Three cases developed grade 1 cardiac disorder, including asymptomatic sinus bradycardia and asymptomatic ventricular premature beat, respectively. In addition, other reactions including fatigue (four cases in grade 1 and one case in grade 2), fever (four cases). All patients had no abnormal liver function, kidney function, constipation and leukoencephalopathy (Table 2). CONCLUSION: This study has been the first prospective clinical study of pemetrexed combined with lenalidomide in the treatment of patients with relapsed/refractory PCNSL in international. The results indicate that chemotherapy with pemetrexed combined with lenalidomide may be an effective therapy for the treatment of relapsed/refractory PCNSL with modest toxicity. KEYWORDS: Primary central nervous system lymphoma; Relapse/refractory; Pemetrexed combined with lenalidomide; Efficacy; Safety Disclosures No relevant conflicts of interest to declare.

Gamma Knife Radiosurgery in AIDS-Related Primary Central Nervous System Lymphoma

1995 ◽  
Vol 64 (1) ◽  
pp. 42-55 ◽  
Author(s):  
A. Nicolato ◽  
M.A. Gerosa ◽  
R. Foroni ◽  
E. Piovan ◽  
P.G. Zampieri ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Central Nervous System Lymphoma

scholarly journals RT-23 * THE ROLE OF GAMMA KNIFE RADIOSURGERY IN THE TREATMENT FOR PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMAS

2014 ◽  
Vol 16 (suppl 5) ◽  
pp. v192-v192
Author(s):  
K. Mori ◽  
Y. Chiba ◽  
S. Toyota ◽  
T. Kumagai ◽  
S. Yamamoto ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery

Gamma Knife surgery for primary central nervous system lymphoma: usefulness as palliative local tumor control

2006 ◽  
Vol 105 (Supplement) ◽  
pp. 133-138 ◽  
Author(s):  
Hiroyuki Kenai ◽  
Masanori Yamashita ◽  
Takaharu Nakamura ◽  
Tomoshige Asano ◽  
Yasutomo Momii ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Central Nervous System ◽  
Nervous System ◽  
Gamma Knife ◽  
Central Nervous System Lymphoma ◽  
Local Tumor Control ◽  
Gamma Knife Surgery ◽  
Tumor Control ◽  
Local Tumor

ObjectAlthough there is no established treatment for primary central nervous system lymphoma (PCNSL), therapeutic protocols involving high-dose methotrexate therapy followed, in some cases, by whole-brain radiotherapy (WBRT) have generally been adopted, and they have yielded relatively favorable results. Gamma Knife surgery (GKS) is a stopgap measure to treat patients with PCNSL. The authors summarize the results of their cases and evaluate the efficacy and usefulness of GKS.MethodsBetween June 1999, and June 2005, 22 patients suffering from PCNSL were treated with GKS at the authors' institution and were followed up for more than 6 months. Some combination of chemotherapy and/or WBRT and/or microsurgery had been performed in 18 of the 22 patients before GKS. The remaining four patients had not undergone any previous treatment. In these patients, the mean tumor volume was 4.14 cm3, and the tumors were treated with a mean margin dose of 16.5 Gy to the 52.8% isodose line. Magnetic resonance imaging demonstrated the disappearance of the GKS-treated lesions; however, new lesions were observed in other regions of the brain in 10 patients and repeated GKS was performed in some cases. No local recurrences were observed an average of 19.4 months after GKS, and good level of quality of life (QOL) was maintained during this period.Conclusions Gamma Knife surgery should be performed only for local tumor control as a stopgap measure in the treatment of PCNSL. It is noninvasive and safe, and its effects occur rapidly. Its use improves prognosis and enhances the patient's quality of life. Gamma Knife surgery should be considered one of the treatment strategies for patients with PCNSLs.

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