P11.08.B R-MPV THERAPY FOR PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA; SINGLE CENTER RETROSPECTIVE ANALYSIS

Abstract

Abstract BACKGROUND Whole brain radiation therapy (WBRT) to primary central nervous system lymphoma (PCNSL) correlate with brain atrophy and leukoencephalopathy, negatively impacting cognitive function and quality of life. R-MPV with reduced WBRT or without WBRT has recently been reported to improve the outcomes of PCNSL. Here we retrospectively analyzed newly diagnosed PCNSL patients to compare the outcome and toxicity of R-MPV therapy with these of WBRT following R-MTX therapy in a real-life setting. MATERIAL AND METHODS Sixty newly histological diagnosed PCNSL patients were retrospectively evaluated. Clinical data from the database included patient characteristics, response rate, adverse effects, overall survival and radiological brain atrophy at 1 year; whole brain volume (mm2) calculated from BainLab automatically. Thirty-one patients were received WBRT (30Gy) following R-MTX therapy (R-MTX-RT group) and 29 patients were received R-MPV therapy (R-MPV group). RESULTS The mean age at symptom onset was significantly younger in R-MTX-RT group than in R-MPV group (64 vs 74 years, p=0.014). Complete response rate after chemotherapy was higher in R-MPV group (58% in R-MTX-RT group and 88% in R-MPV group). However, overall survival was not significant difference (53.5 month in R-MTX-RT group, 52.7 month in R-MPV group). Three patients of 31 (9.6%) in R-MTX-RT group and 6 patients (20%) in R-MPV group were not able to complete the chemotherapy regimen. Notably, patients >75 years of age sometimes had severe adverse effect with R-MPV therapy. Treatment rerated death was not significant difference in both group (3% in R-MTX-RT vs 13% in R-MPV group, Fisher’s exact test p=0.19). Brain atrophy at 1 year was significantly lesser in R-MPV group than in R-MTX-RT group (R-MTX group, n=17; 4.03%, R-MPV group, n=15; 0.95%, p=0.005). CONCLUSION R-MPV therapy has benefit of avoiding WBRT in PCNSL patients. However, elderly patients exhibit increased risk for adverse events of R-MPV.