Long-Term Survivors Of A Systemic And Intraventricular Chemotherapy With Deferred Radiotherapy In Primary Central Nervous System Lymphoma (Pcnsl)

8557 Background: To evaluate survival, quality of life and neurotoxic sequelae in long-term survivors with primary central nervous system lymphoma (PCNSL) after systemic and intraventricular chemotherapy with deferred radiotherapy. Patients and Methods: From 09/1995 to 12/2001, 65 patients with PCNSL (median age 62 years) were enrolled in a pilot/phase II study evaluating chemotherapy without radiotherapy; thirty patietns were younger than 60 years. A high-dose methotrexate (MTX) (cycles 1,2,4,5) and cytarabine (ara-C) (cycles 3,6) based systemic therapy (including dexamethasone, vinca-alkaloids, ifosfamide and cyclophosphamide) was combined with intraventricular MTX, prednisolone and ara-C. All living patients were contacted, a neurological examination, comprehensive neuropsychological testing, Quality of Life (QoL) - Assessment (EORTC QLQ-C30 (Version 3.0) und EORTC QLQ-BN20) and imaging were performed. Results: Twenty-one of 65 patients (32 %) are alive. Of these, 17 patients were younger than 60 years at diagnosis, resulting in long-termsurvival rate of 17 of 30 patients (57 %). Median follow up is 99.5 months (range, 70 to 147 months) in surviving patients. Seventeen/21 patients completed all investigations, in three patients test results are pending, one is lost to follow up. One patient is currently undergoing therapy for tumor relapse; one other patient developed a second malignoma (liposarcoma). In three patients, a pure extraneural relapse was diagnosed after nine, 31 and 40 months and showed complete remission to high-dose chemotherapy in all. There was no evidence of late onset neurotoxity nor compromise of therapy- or tumor-related QoL measures in any of the examined patients. Conclusions: Primary polychemotherapy based on high- dose MTX and ara-C is highly efficient in PCNSL. More than half of patients < 60 years can obviously be cured with this regimen without suffering from long term neurotoxic sequelae. No significant financial relationships to disclose.