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NOA-03 trial of high-dose methotrexate
in primary central nervous system lymphoma: final report
Herrlinger U, Kuker W, Uhl M, Blaicher HP,
Karnath HO, Kanz L, Bamberg M, Weller M; Neuro-Oncology
Working Group of the German Society.
Department of General Neurology, Hertie Institute for Clinical
Brain Research, Tubingen, Germany. ulrich.herrlinger@uni-tuebingen.de
The NOA-03 trial explored high-dose methotrexate alone in 37 patients
with primary central nervous system lymphoma.
The overall median survival was 25
months.
After 4 years, the rate of
leukoencephalopathy in patients surviving more than 12 months was 58%
with and 10% without whole-brain radiotherapy given at relapse (p =
0.11).
Attention deficits were found in all six
tested patients, and memory deficits in four patients.
Two patients had normal, three had
moderately restricted, and one had markedly restricted quality of
life.
Thus, high-dose methotrexate with deferred
radiotherapy had only moderate efficacy and was associated with
significant neurotoxicity in long-term surviving patients.
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