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Titolo:
Rapid infusion of high-dose methotrexate resulting in enhanced penetrationinto cerebrospinal fluid and intensified tumor response in primary centralnervous system lymphomas
Autore:
Hiraga, S; Arita, N; Ohnishi, T; Kohmura, E; Yamamoto, K; Oku, Y; Taki, T; Sato, M; Aozasa, K; Yoshimine, T;
Indirizzi:
Osaka Univ, Sch Med, Dept Neurosurg, Suita, Osaka 5650871, Japan Osaka Univ Suita Osaka Japan 5650871 urosurg, Suita, Osaka 5650871, Japan Osaka Univ, Sch Med, Dept Pathol, Suita, Osaka 5650871, Japan Osaka Univ Suita Osaka Japan 5650871 Pathol, Suita, Osaka 5650871, Japan Osaka Rosai Hosp, Dept Neurosurg, Osaka, Japan Osaka Rosai Hosp Osaka Japan a Rosai Hosp, Dept Neurosurg, Osaka, Japan Kansai Rosai Hosp, Dept Neurosurg, Osaka, Japan Kansai Rosai Hosp Osaka Japan Rosai Hosp, Dept Neurosurg, Osaka, Japan Toyonaka Municipal Hosp, Dept Neurosurg, Osaka, Japan Toyonaka Municipal Hosp Osaka Japan Hosp, Dept Neurosurg, Osaka, Japan
Titolo Testata:
JOURNAL OF NEUROSURGERY
fascicolo: 2, volume: 91, anno: 1999,
pagine: 221 - 230
SICI:
0022-3085(199908)91:2<221:RIOHMR>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
PRIMARY CNS LYMPHOMA; NON-HODGKINS-LYMPHOMA; PRIMARY BRAIN LYMPHOMA; RADIATION-THERAPY; MENINGEAL LEUKEMIA; LEUCOVORIN RESCUE; CITROVORUM FACTOR; CHEMOTHERAPY; RADIOTHERAPY; SURVIVAL;
Keywords:
lymphoma; methotrexate; central nervous system; rapid infusion;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
61
Recensione:
Indirizzi per estratti:
Indirizzo: Hiraga, S Osaka Univ, Sch Med, Dept Neurosurg, 2-2 Yamadaoka, Suita, Osaka5650871, Japan Osaka Univ 2-2 Yamadaoka Suita Osaka Japan 5650871 650871, Japan
Citazione:
S. Hiraga et al., "Rapid infusion of high-dose methotrexate resulting in enhanced penetrationinto cerebrospinal fluid and intensified tumor response in primary centralnervous system lymphomas", J NEUROSURG, 91(2), 1999, pp. 221-230

Abstract

Object. Twenty-nine nonimmunocompromised patients with primary central nervous system (CNS) lymphoma were treated with high-dose methotrexate (MTX) therapy followed by irradiation. The authors investigated the correlation ofinfusion schedules with MTX penetration into cerebrospinal fluid (CSF), tumor response, and survival to develop a regimen that would lead to better clinical results. Methods. In this study, 100 mg/kg MTX was administered on either a rapid (3-hour) or regular (6-hour) infusion schedule for two or three cycles. Of 28 assessable patients, a complete or partial response was achieved in 15 (93.8%) of 16 who received rapid and in seven (58.3%) of 12 who received regular infusion therapy (p = 0.034). Rapid infusion significantly increased levels of MTX in the CSF (p < 0.001) and resulted in significant tumor volumereduction (p < 0.001). The mean tumor volume after the first, second, and third cycle of rapid infusion therapy was reduced to 34%, 14%, and 9%, respectively, of the initial volume, whereas the corresponding values were 54%,42%, and 37% for regular infusion. The reduction between the second and third cycle was small and not significant for either schedule. Despite the longer median survival time in patients who underwent rapid MTX infusion and irradiation (>60 compared with 20 months), the difference in survival was not significant (p = 0.147) because of the small number of patients enrolled. The median survival time was 39.3 months for all assessable patients who received high-dose MTX and radiation therapy, and the median relapse-free survival time was 35.2 months. Conclusions. Rapid infusion enhanced both MTX penetration into the CSF andtumor response and may improve patient survival. Administration of three or more cycles of therapy should be carefully weighed in terms of cytoreductive benefits.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 20:11:49