Primary central nervous system lymphoma: Phase I evaluation of infusional bromodeoxyuridine with whole brain accelerated fractionation radiation therapy after chemotherapy

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dc.contributor.authorDabaja, B. S.en
dc.contributor.authorMcLaughlin, P.en
dc.contributor.authorHa, C. S.en
dc.contributor.authorPro, B.en
dc.contributor.authorMeyers, C. A.en
dc.contributor.authorSeabrooke, L. F.en
dc.contributor.authorWilder, R. B.en
dc.contributor.authorKyritsis, A. P.en
dc.contributor.authorPreti, H. A.en
dc.contributor.authorYung, W. K.en
dc.contributor.authorLevin, V.en
dc.contributor.authorCabanillas, F.en
dc.contributor.authorCox, J. D.en
dc.date.accessioned2015-11-24T18:56:38Z
dc.date.available2015-11-24T18:56:38Z
dc.identifier.issn0008-543X-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/19070
dc.rightsDefault Licence-
dc.subjectAdulten
dc.subjectAgeden
dc.subjectAntimetabolites, Antineoplastic/administration & dosage/*adverseen
dc.subjecteffects/*pharmacologyen
dc.subjectAntineoplastic Combined Chemotherapy Protocols/*therapeutic useen
dc.subjectBrain Diseases/chemically induceden
dc.subjectBromodeoxyuridine/administration & dosage/*adverse effects/*pharmacologyen
dc.subjectCentral Nervous System Neoplasms/*drug therapy/pathology/*radiotherapyen
dc.subjectCisplatin/administration & dosageen
dc.subjectCombined Modality Therapyen
dc.subject*Cranial Irradiationen
dc.subjectCytarabine/administration & dosageen
dc.subjectDexamethasone/administration & dosageen
dc.subjectDose-Response Relationship, Drugen
dc.subjectFemaleen
dc.subjectHumansen
dc.subjectIdarubicin/administration & dosageen
dc.subjectInfusions, Intravenousen
dc.subjectLymphoma/*drug therapy/pathology/*radiotherapyen
dc.subjectMaleen
dc.subjectMethotrexate/administration & dosageen
dc.subjectMiddle Ageden
dc.subjectTreatment Outcomeen
dc.titlePrimary central nervous system lymphoma: Phase I evaluation of infusional bromodeoxyuridine with whole brain accelerated fractionation radiation therapy after chemotherapyen
heal.abstractBACKGROUND: The current study was performed to determine the maximum tolerated dose (MTD), toxicity, and outcome of infusional 5 bromo-2'-deoxyuridine (bromodeoxyuridine; BUdR) given with accelerated fractionation whole brain radiation therapy (WBRT) after chemotherapy for the treatment of primary central nervous system lymphoma (PCNSL). METHODS: Twelve patients with untreated and histologically confirmed PCNSL were entered on the study between 1994 and 1996. Chemotherapy was comprised of one course of IDHAP plus high-dose methotrexate (HD-MTX). IDHAP is comprised of idarubicin at a dose of 1.5 mg/m(2)/day x 4 days intravenously by continuous infusion (i.v. CI), dexamethasone at a dose of 40 mg i.v. on Days 1-5, cytosine arabinoside at a dose of 2000 mg/ m(2) i.v. on Day 5 after cisplatin, and cisplatin at a dose of 25 mg/m(2)/day x 4 days i.v. CI. HD-MTX was given at a dose of 3.5 g/m(2) i.v. between Day 10 and Day 14 after IDHAP. BUdR was given as an i.v. CI over 48 hours, 2-3 days prior to WBRT and then weekly during WBRT. Dose escalation started at 1.5 g/m(2)/day for Cohort 1 with subsequent increments of 0.3 g/m(2)/day. The WBRT dose was 45 grays (Gy) at a dose of 1.5 Gy twice a day, 5 days per week. Neurocognitive testing was performed before, during, and after treatment. RESULTS: Nine of 12 patients entered on the study received BUdR. One of 3 patients in Cohort 1 developed leukoencephalopathy (LEP), a dose-limiting toxicity (DLT), within 2 months of the completion of therapy. Therefore, the next cohort received the same dose level. Because no toxicity was observed in Cohort 2, the third cohort received a BUdR dose of 1.8 g /m(2)/day. Shortly after completing enrollment in Cohort 3, 3 more patients developed LEP, including 2 from Cohort 1 who had received a dose of 1.5 g/m(2)/day. Thus, DLT occurred at a dose of 1.5 g/m(2)/day, the starting level in the current study. As a result, the trial was stopped. Eight of 12 patients achieved a complete response, 3 achieved a partial response, and 1 patient died before response assessment. CONCLUSIONS: Hyperfractionated WBRT with concurrent BUdR after chemotherapy was found to result in modest disease control but has unacceptable neurotoxicity.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.primary10.1002/cncr.11627-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/12942571-
heal.identifier.secondaryhttp://onlinelibrary.wiley.com/store/10.1002/cncr.11627/asset/11627_ftp.pdf?v=1&t=h0b2ddcp&s=ed8be3239b77b0d797be0a632510b52a70d664ec-
heal.journalNameCanceren
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2003-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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