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Radiotherapy or Autologous Stem-Cell Transplantation for Primary CNS Lymphoma in Patients 60 Years of Age and Younger: Results of the Intergroup ANOCEF-GOELAMS Randomized Phase II PRECIS Study

Houillier, Caroline, Taillandier, Luc, Dureau, Sylvain, Lamy, Thierry, Laadhari, Mouna, Chinot, Olivier, Moluçon-Chabrot, Cecile, Soubeyran, Pierre, Gressin, Remy, Choquet, Sylvain, Damaj, Gandhi, Thyss, Antoine, Abraham, Julie, Delwail, Vincent, Gyan, Emmanuel, Sanhes, Laurence, Cornillon, Jérôme, Garidi, Reda, Delmer, Alain, Tanguy, Marie-Laure, Al Jijakli, Ahmad, Morel, Pierre, Bourquard, Pascal, Moles, Marie-Pierre, Chauchet, Adrien, Gastinne, Thomas, Constans, Jean-Marc, Langer, Adriana, Martin, Antoine, Moisson, Patricia, Lacomblez, Lucette, Martin-Duverneuil, Nadine, Delgadillo, Daniel, Turbiez, Isabelle, Feuvret, Loïc, Cassoux, Nathalie, Touitou, Valérie, Ricard, Damien, Hoang-Xuan, Khê, Soussain, Carole, on behalf of the Intergroupe GOELAMS–ANOCEF and the LOC Network for CNS Lymphoma·2019·Journal of Clinical Oncology

Abstract

PURPOSE: To determine the efficacy and toxicity of chemoimmunotherapy followed by either whole-brain radiotherapy (WBRT) or intensive chemotherapy and autologous stem-cell transplantation (ASCT) as a first-line treatment of primary CNS lymphoma (PCNSL). PATIENTS AND METHODS: Immunocompetent patients (18 to 60 years of age) with untreated PCNSL were randomly assigned to receive WBRT or ASCT as consolidation treatment after induction chemotherapy consisting of two cycles of R-MBVP (rituximab 375 mg/m 2 day (D) 1, methotrexate 3 g/m 2 D1; D15, VP16 100 mg/m 2 D2, BCNU 100 mg/m 2 D3, prednisone 60 mg/m 2/d D1-D5) followed by two cycles of R-AraC (rituximab 375 mg/m 2 D1, cytarabine 3 g/m 2/D, D1, and D2). Intensive chemotherapy consisted of thiotepa (250 mg/m 2/d D9; D8; D7), busulfan (8 mg/kg D6 through D4), and cyclophosphamide (60 mg/kg/d D3; D2). WBRT delivered 40 Gy (2 Gy/fraction). The primary end point was 2-year progression-free survival. Cognitive outcome was the main secondary end point. Analysis was intention to treat in a noncomparative phase II trial. RESULTS: Between October 2008 and February 2014, 140 patients were recruited from 23 French centers. Both WBRT and ASCT met the predetermined threshold (among the first 38 patients in each group, at least 24 patients were alive and disease free at 2 years). The 2-year progression-free survival rates were 63% (95% CI, 49% to 81%) and 87% (95% CI, 77% to 98%) in the WBRT and ASCT arms, respectively. Toxicity deaths were recorded in one and five patients after WBRT and ASCT, respectively. Cognitive impairment was observed after WBRT, whereas cognitive functions were preserved or improved after ASCT. CONCLUSION: WBRT and ASCT are effective consolidation treatments for patients with PCNSL who are 60 years of age and younger. The efficacy end points tended to favor the ASCT arm. The specific risk of each procedure should be considered.

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Authors
Houillier, C., Taillandier, L., Dureau, S., Lamy, T., Laadhari, M., Chinot, O., Moluçon-Chabrot, C., Soubeyran, P., Gressin, R., Choquet, S., Damaj, G., Thyss, A., Abraham, J., Delwail, V., Gyan, E., Sanhes, L., Cornillon, J., Garidi, R., Delmer, A., Tanguy, M.-L., Al Jijakli, A., Morel, P., Bourquard, P., Moles, M.-P., Chauchet, A., Gastinne, T., Constans, J.-M., Langer, A., Martin, A., Moisson, P., Lacomblez, L., Martin-Duverneuil, N., Delgadillo, D., Turbiez, I., Feuvret, L., Cassoux, N., Touitou, V., Ricard, D., Hoang-Xuan, K., Soussain, C., & on behalf of the Intergroupe GOELAMS–ANOCEF and the LOC Network for CNS Lymphoma
Venue
Journal of Clinical Oncology
Published
2019-04-01
Volume
37
Issue
10
Pages
823-833
ISSN
  • 0732-183X (ISSN-L)
  • 1527-7755
OpenAlex
W2917478934
Cited by
287
References
15
FWCI
19.57
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Radiotherapy or Autologous Stem-Cell Transplantation for Primary CNS Lymphoma in Patients 60 Years of Age and Younger: Results of the Intergroup ANOCEF-GOELAMS Randomized Phase II PRECIS Study. https://app.cochat.ai/papers/10.1200/jco.18.00306
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Houillier, C., Taillandier, L., Dureau, S., Lamy, T., Laadhari, M., Chinot, O., Moluçon-Chabrot, C., Soubeyran, P., Gressin, R., Choquet, S., Damaj, G., Thyss, A., Abraham, J., Delwail, V., Gyan, E., Sanhes, L., Cornillon, J., Garidi, R., Delmer, A., . . . on behalf of the Intergroupe GOELAMS–ANOCEF and the LOC Network for CNS Lymphoma. (2019). Radiotherapy or Autologous Stem-Cell Transplantation for Primary CNS Lymphoma in Patients 60 Years of Age and Younger: Results of the Intergroup ANOCEF-GOELAMS Randomized Phase II PRECIS Study. Journal of Clinical Oncology. https://doi.org/10.1200/jco.18.00306

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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