PRELIMINARY-RESULTS OF COMBINED CHEMOTHERAPY AND RADIOTHERAPY FOR NON-AIDS PRIMARY CENTRAL-NERVOUS-SYSTEM LYMPHOMA

Objectives: To assess the results and toxicity of a regimen of combine d chemotherapy and radiotherapy for patients with non-AIDS-related pri mary central nervous system lymphoma. Design: Prospective assessment o f patients treated with intravenous methotrexate followed by cranial i rradiation between 1 January 1991 and 31 July 1995. Patients and setti ng: Patients attending nine Australian and New Zealand centres who wer e eligible and gave informed consent. Main outcome measures: Probabili ty of survival at two years, and acute toxicity. Results: Twenty-four patients were treated. Their probability of survival at two years was 70% (95% confidence interval [CI], 45%-95%). The acute toxicity of the regimen was minimal in most cases, but one patient died of treatment- related neutropenia and subsequent sepsis. Two patients showed progres sion of pre-existing short term memory disturbance, without evidence o f recurrent lymphoma. Conclusions: Combined-modality therapy improves survival in patients with non-AIDS-related primary central nervous sys tem lymphoma, at least in the short term, relative to radiotherapy alo ne. The combined regimen resulted in only moderate treatment-related m orbidity. Longer follow-up is required for a more accurate estimate of late effects and long-term survival prospects.