Fotemustine-based therapy in combination with rituximab as a first-line induction chemotherapy followed by WBRT for newly diagnosed primary central nervous system lymphoma: a prospective phase II trial

作     者：Jingjing Wu Fenghua Gao Wenhua Wang Xudong Zhang Meng Dong Lei Zhang Xin Li Ling Li Zhenchang Sun Xinhua Wang Xiaorui Fu Linan Zhu Mengjie Ding Songtao Niu Zhaoming Li Yu Chang Feifei Nan Jiaqian Yan Hui Yu Xiaolong Wu Zhiyuan Zhou Jieming Zhang Mingzhi Zhang Jingjing Wu;Fenghua Gao;Wenhua Wang;Xudong Zhang;Meng Dong;Lei Zhang;Xin Li;Ling Li;Zhenchang Sun;Xinhua Wang;Xiaorui Fu;Linan Zhu;Mengjie Ding;Songtao Niu;Zhaoming Li;Yu Chang;Feifei Nan;Jiaqian Yan;Hui Yu;Xiaolong Wu;Zhiyuan Zhou;Jieming Zhang;Mingzhi Zhang

作者机构：Cancer Research InstituteDepartment of OncologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052HenanChina 

出 版 物：《Cancer Biology & Medicine》 (癌症生物学与医学（英文版）)

年 卷 期：2022年第19卷第7期

页      面：1089-1099页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：supported by grants from the National Natural Science Foundation of China(Grant No.81970184),The National Science and Technology Major Project of China(Grant No.2020ZX09201-009) Henan Medical Science and Technology Tacking Program(Joint Project)(Grant No.LHGJ20190021) 

主　　题：Rituximab primary central nervous system lymphoma pemetrexed fotemustine WBRT 

摘      要：Objective:This study aimed to evaluate the safety,efficacy,and feasibility of the rituximab,fotemustine,pemetrexed,and dexamethasone(R-FPD)regimen followed by whole-brain radiotherapy(WBRT)for patients with primary central nervous system lymphoma(PCNSL).Methods:A prospective,single-center phase II clinical trial was *** with PCNSL newly diagnosed at the First Affiliated Hospital of Zhengzhou University between July 2018 and July 2020 were *** R-FPD regimen consisted of rituximab(375 mg/m2 *** D0),fotemustine(100 mg/m2 *** D1),pemetrexed(600 mg/m2 *** D1),and dexamethasone(40 mg *** D1-5).Patients 60 years or younger who showed a complete response(CR)were treated with 23.4 Gy of WBRT after the end of chemotherapy;those older than 60 years with CR were treated with a wait-and-see approach;and those who did not show CR after the 4th cycle of chemotherapy were given salvage WBRT 30 Gy+local tumor field irradiation up to 45 Gy,regardless of ***:A total of 30 patients were *** 2 cycles,the objective response rate(ORR)was 96.5%(28/29,1 CR,27 PR,0 SD,and 1 PD).After 4 cycles,the ORR was 73.1%(19/26,11 CR,8 PR,4 SD,and 3 PD).After WBRT,the ORR was 90.9%(10/11,7 CR,3 PR,and 1 SD).The grade III and IV toxicity responses were mainly leukopenia(20.0%),thrombocytopenia(23.3%),and anemia(10.0%).Conclusions:Fotemustine-based therapy in combination with rituximab chemotherapy followed by WBRT can improve outcomes,providing ORR benefits and favorable tolerability in patients newly diagnosed with PCNSL.