E-resources
-
Korfel, Agnieszka; Thiel, Eckhard; Martus, Peter; Möhle, Robert; Griesinger, Frank; Rauch, Michael; Röth, Alexander; Hertenstein, Bernd; Fischer, Thomas; Hundsberger, Thomas; Mergenthaler, Hans G; Junghan, Christian; Birnbaum, Tobias; Fischer, Lars; Jahnke, Kristoph; Herrlinger, Ulrich; Roth, Patrick; Bamberg, Michael; Pietsch, Torsten; Weller, Michael
Neurology, 2015-March-24, 2015-Mar-24, 2015-03-24, 20150324, Volume: 84, Issue: 12Journal Article
OBJECTIVE:This is the final report of a phase III randomized study to evaluate whole-brain radiotherapy (WBRT) in primary therapy of primary CNS lymphoma (PCNSL) after a median follow-up of 81.2 months. METHODS:Patients with newly diagnosed PCNSL were randomized to high-dose methotrexate (HDMTX)–based chemotherapy alone or followed by WBRT. We hypothesized that the omission of WBRT would not compromise overall survival (OS; primary endpoint), using a noninferiority design with a margin of 0.9. RESULTS:In the per-protocol population (n = 320), WBRT nonsignificantly prolonged progression-free survival (PFS) (median 18.2 vs 11.9 months, hazard ratio HR 0.83 95% confidence interval (CI) 0.65–1.06, p = 0.14) and significantly PFS from last HDMTX (25.5 vs 12.0 months, HR 0.65 95% CI 0.5–0.83, p = 0.001), but without OS prolongation (35.6 vs 37.1 months, HR 1.03 95% CI 0.79–1.35, p = 0.82). In the intent-to-treat population (n = 410), there was a prolongation by WBRT of both PFS (15.4 vs 9.9 months, HR 0.79 95% CI 0.64–0.98, p = 0.034) and PFS from last HDMTX (19.4 vs 11.9 months, HR 0.72 95% CI 0.58–0.89, p = 0.003), but not of OS (32.4 vs 36.1 months, HR 0.98 95% CI 0.79–1.26, p = 0.98). CONCLUSION:Although the statistical proof of noninferiority regarding OS was not given, our results suggest no worsening of OS without WBRT in primary therapy of PCNSL. CLASSIFICATION OF EVIDENCE:This study provides Class II evidence that in PCNSL HDMTX-based chemotherapy followed by WBRT does not significantly increase survival compared to chemotherapy alone. The study lacked the precision to exclude an important survival benefit or harm from WBRT.
Author
![loading ... loading ...](themes/default/img/ajax-loading.gif)
Shelf entry
Permalink
- URL:
Impact factor
Access to the JCR database is permitted only to users from Slovenia. Your current IP address is not on the list of IP addresses with access permission, and authentication with the relevant AAI accout is required.
Year | Impact factor | Edition | Category | Classification | ||||
---|---|---|---|---|---|---|---|---|
JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
Select the library membership card:
If the library membership card is not in the list,
add a new one.
DRS, in which the journal is indexed
Database name | Field | Year |
---|
Links to authors' personal bibliographies | Links to information on researchers in the SICRIS system |
---|
Source: Personal bibliographies
and: SICRIS
The material is available in full text. If you wish to order the material anyway, click the Continue button.