Cyclophosphamide, doxorubicin, vincristine, and prednisone for primary central nervous system lymphoma: Short–duration response and multifocal intracerebral recurrence preceding radiotherapy

D. H. Lachance, D. M. Brizel, J. P. Gockerman, E. C. Halperin, P. C. Burger, O. B. Boyko, M. T. Brown, S. C. Schold

91 Scopus citations

Abstract

The activity of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) in the treatment of primary central nervous system lymphoma (PCNSL) prior to radiotherapy was studied in six patients. Primary lesions were reduced by 80% or more on contrast–enhancing cross–sectional area in four patients and to a lesser extent in two others after two cycles of chemotherapy. The primary lesion sites demonstrated no contrast enhancement in the three patients who completed four cycles of therapy. However, concurrent with response at the primary disease sites, multiple lesions occurred at distant, noncontiguous CNS parenchymal sites in five patients after two to four cycles of chemotherapy. Median survival was 8.5 months for the six enrolled patients and 16.5 months for the four patients completing craniospinal radiotherapy. PCNSL is highly responsive to standard systemic non–Hodgkin's lymphoma chemotherapy regimens, but the pattern and rapidity of relapse suggest mechanisms of failure including inherent or rapidly evolving antineoplastic drug resistance and perhaps limited drug delivery to occult sites of disease in the brain.

Original languageEnglish (US)
Pages (from-to)1721-1727
Number of pages7
JournalNeurology
Volume44
Issue number9
StatePublished - Sep 1994

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Cyclophosphamide, doxorubicin, vincristine, and prednisone for primary central nervous system lymphoma : Short–duration response and multifocal intracerebral recurrence preceding radiotherapy. / Lachance, D. H.; Brizel, D. M.; Gockerman, J. P.; Halperin, E. C.; Burger, P. C.; Boyko, O. B.; Brown, M. T.; Schold, S. C.

In: Neurology, Vol. 44, No. 9, 09.1994, p. 1721-1727.

Research output: Contribution to journalArticle