Intensive chemoimmunotherapy and bilateral globe irradiation as initial therapy for primary intraocular lymphoma

Chan Yoon Cheah, Sarah Milgrom, Dai Chihara, Dan S. Gombos, Chelsea C. Pinnix, Bouthaina S. Dabaja, Nathan H. Fowler

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Background. Primary intraocular lymphoma is a rare variant of primary CNS lymphoma for which the optimum treatment strategy remains unknown. Methods. We performed a retrospective single-center study including patients who underwent uniform management from October 2007 in which patients were offered sequential rituximab, methotrexate, procarbazine, and vincristine (R-MPV) followed by binocular radiotherapy and consolidative high-dose cytarabine. Results. Eleven patients with median age 66 years (range, 48-72) were included. All patients received binocular radiotherapy to a median dose of 36 Gy (range, 30.6-39.6) in 20 fractions. Grade 3+ anemia, thrombocytopenia, and neutropenia occurred in 1 (9%), 2 (18%), and 3 (27%) patients, respectively; raised creatinine and peripheral sensory neuropathy occurred in 4 (36%) and 3 (27%) patients, respectively. Grade 3+ ocular toxicities included cataract formation and keratitis in 6 (54%) and 3 (27%) patients, respectively. Ten patients (91%) achieved complete response and 1 (9%) partial response. After median follow-up of 4.2 years (range, 1.8-7.6), the median progression-free survival was 3.8 years and the estimated 4-year overall survival was 75.8% (95% CI: 30.5%-93.7%). The initial site of disease progression was the CNS in 4 of 7 patients (57%) and within the eye in 3 of 7 (43%). Five patients achieved responses to salvage therapies. Conclusions. Combined modality treatment with R-MPV, binocular radiation, and high-dose cytarabine is effective with moderate toxicity. Both local and CNS relapses occur; however, the achievement of second and subsequent remissions is possible.

Original languageEnglish (US)
Pages (from-to)575-581
Number of pages7
JournalNeuro-oncology
Volume18
Issue number4
DOIs
StatePublished - Apr 1 2016

Keywords

  • methotrexate
  • primary central nervous system lymphoma
  • primary intraocular lymphoma
  • radiotherapy
  • treatment

ASJC Scopus subject areas

  • Oncology
  • Clinical Neurology
  • Cancer Research

Fingerprint Dive into the research topics of 'Intensive chemoimmunotherapy and bilateral globe irradiation as initial therapy for primary intraocular lymphoma'. Together they form a unique fingerprint.

Cite this