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Randomized phase III study of whole-brain radiotherapy for primary CNS lymphoma.

  • Korfel A From the Department of Hematology, Oncology and Tumor Immunology (A.K., E.T., L.F., K.J.), Charité Berlin; the Departments of Clinical Epidemiology and Applied Biostatistics (P.M.) and Hematology and Oncology (R.M.), University Tübingen; the Department of Radiotherapy and Medical Oncology (F.G.), Pius Hospital Oldenburg; the Department of Neurology (M.R.), Protestant Hospital Bielefeld; the Department of Hematology (A.R.), University Hospital Essen; the Department of Internal Medicine (B.H.), Hospital Bremen Center; the Department of Hematology and Oncology (T.F.), University Hospital Magdeburg; the Department of Neurology (T.H.), University Hospital Mainz; the Department of Hematology and Oncology (H.G.M.), Klinikum Stuttgart; the Department of Hematology and Oncology (C.J.), University Hospital Rostock; the Department of Neurology (T.B.), University Hospital Munich LMU; the Departments of Neurology (U.H., P.R., M.W.) and Radiation Oncology (M.B.), University Hospital Tübingen; the Department of Neurology (U.H.), University Bonn, Germany; the Department of Neurology (P.R., M.W.), University Hospital Zurich, Switzerland; and the Institute of Neuropathology (T.P.), University Hospital Bonn, Germany. agnieszka.korfel@charite.de.
  • Thiel E From the Department of Hematology, Oncology and Tumor Immunology (A.K., E.T., L.F., K.J.), Charité Berlin; the Departments of Clinical Epidemiology and Applied Biostatistics (P.M.) and Hematology and Oncology (R.M.), University Tübingen; the Department of Radiotherapy and Medical Oncology (F.G.), Pius Hospital Oldenburg; the Department of Neurology (M.R.), Protestant Hospital Bielefeld; the Department of Hematology (A.R.), University Hospital Essen; the Department of Internal Medicine (B.H.), Hospital Bremen Center; the Department of Hematology and Oncology (T.F.), University Hospital Magdeburg; the Department of Neurology (T.H.), University Hospital Mainz; the Department of Hematology and Oncology (H.G.M.), Klinikum Stuttgart; the Department of Hematology and Oncology (C.J.), University Hospital Rostock; the Department of Neurology (T.B.), University Hospital Munich LMU; the Departments of Neurology (U.H., P.R., M.W.) and Radiation Oncology (M.B.), University Hospital Tübingen; the Department of Neurology (U.H.), University Bonn, Germany; the Department of Neurology (P.R., M.W.), University Hospital Zurich, Switzerland; and the Institute of Neuropathology (T.P.), University Hospital Bonn, Germany.
  • Martus P From the Department of Hematology, Oncology and Tumor Immunology (A.K., E.T., L.F., K.J.), Charité Berlin; the Departments of Clinical Epidemiology and Applied Biostatistics (P.M.) and Hematology and Oncology (R.M.), University Tübingen; the Department of Radiotherapy and Medical Oncology (F.G.), Pius Hospital Oldenburg; the Department of Neurology (M.R.), Protestant Hospital Bielefeld; the Department of Hematology (A.R.), University Hospital Essen; the Department of Internal Medicine (B.H.), Hospital Bremen Center; the Department of Hematology and Oncology (T.F.), University Hospital Magdeburg; the Department of Neurology (T.H.), University Hospital Mainz; the Department of Hematology and Oncology (H.G.M.), Klinikum Stuttgart; the Department of Hematology and Oncology (C.J.), University Hospital Rostock; the Department of Neurology (T.B.), University Hospital Munich LMU; the Departments of Neurology (U.H., P.R., M.W.) and Radiation Oncology (M.B.), University Hospital Tübingen; the Department of Neurology (U.H.), University Bonn, Germany; the Department of Neurology (P.R., M.W.), University Hospital Zurich, Switzerland; and the Institute of Neuropathology (T.P.), University Hospital Bonn, Germany.
  • Möhle R From the Department of Hematology, Oncology and Tumor Immunology (A.K., E.T., L.F., K.J.), Charité Berlin; the Departments of Clinical Epidemiology and Applied Biostatistics (P.M.) and Hematology and Oncology (R.M.), University Tübingen; the Department of Radiotherapy and Medical Oncology (F.G.), Pius Hospital Oldenburg; the Department of Neurology (M.R.), Protestant Hospital Bielefeld; the Department of Hematology (A.R.), University Hospital Essen; the Department of Internal Medicine (B.H.), Hospital Bremen Center; the Department of Hematology and Oncology (T.F.), University Hospital Magdeburg; the Department of Neurology (T.H.), University Hospital Mainz; the Department of Hematology and Oncology (H.G.M.), Klinikum Stuttgart; the Department of Hematology and Oncology (C.J.), University Hospital Rostock; the Department of Neurology (T.B.), University Hospital Munich LMU; the Departments of Neurology (U.H., P.R., M.W.) and Radiation Oncology (M.B.), University Hospital Tübingen; the Department of Neurology (U.H.), University Bonn, Germany; the Department of Neurology (P.R., M.W.), University Hospital Zurich, Switzerland; and the Institute of Neuropathology (T.P.), University Hospital Bonn, Germany.
  • Griesinger F From the Department of Hematology, Oncology and Tumor Immunology (A.K., E.T., L.F., K.J.), Charité Berlin; the Departments of Clinical Epidemiology and Applied Biostatistics (P.M.) and Hematology and Oncology (R.M.), University Tübingen; the Department of Radiotherapy and Medical Oncology (F.G.), Pius Hospital Oldenburg; the Department of Neurology (M.R.), Protestant Hospital Bielefeld; the Department of Hematology (A.R.), University Hospital Essen; the Department of Internal Medicine (B.H.), Hospital Bremen Center; the Department of Hematology and Oncology (T.F.), University Hospital Magdeburg; the Department of Neurology (T.H.), University Hospital Mainz; the Department of Hematology and Oncology (H.G.M.), Klinikum Stuttgart; the Department of Hematology and Oncology (C.J.), University Hospital Rostock; the Department of Neurology (T.B.), University Hospital Munich LMU; the Departments of Neurology (U.H., P.R., M.W.) and Radiation Oncology (M.B.), University Hospital Tübingen; the Department of Neurology (U.H.), University Bonn, Germany; the Department of Neurology (P.R., M.W.), University Hospital Zurich, Switzerland; and the Institute of Neuropathology (T.P.), University Hospital Bonn, Germany.
  • Rauch M From the Department of Hematology, Oncology and Tumor Immunology (A.K., E.T., L.F., K.J.), Charité Berlin; the Departments of Clinical Epidemiology and Applied Biostatistics (P.M.) and Hematology and Oncology (R.M.), University Tübingen; the Department of Radiotherapy and Medical Oncology (F.G.), Pius Hospital Oldenburg; the Department of Neurology (M.R.), Protestant Hospital Bielefeld; the Department of Hematology (A.R.), University Hospital Essen; the Department of Internal Medicine (B.H.), Hospital Bremen Center; the Department of Hematology and Oncology (T.F.), University Hospital Magdeburg; the Department of Neurology (T.H.), University Hospital Mainz; the Department of Hematology and Oncology (H.G.M.), Klinikum Stuttgart; the Department of Hematology and Oncology (C.J.), University Hospital Rostock; the Department of Neurology (T.B.), University Hospital Munich LMU; the Departments of Neurology (U.H., P.R., M.W.) and Radiation Oncology (M.B.), University Hospital Tübingen; the Department of Neurology (U.H.), University Bonn, Germany; the Department of Neurology (P.R., M.W.), University Hospital Zurich, Switzerland; and the Institute of Neuropathology (T.P.), University Hospital Bonn, Germany.
  • Röth A From the Department of Hematology, Oncology and Tumor Immunology (A.K., E.T., L.F., K.J.), Charité Berlin; the Departments of Clinical Epidemiology and Applied Biostatistics (P.M.) and Hematology and Oncology (R.M.), University Tübingen; the Department of Radiotherapy and Medical Oncology (F.G.), Pius Hospital Oldenburg; the Department of Neurology (M.R.), Protestant Hospital Bielefeld; the Department of Hematology (A.R.), University Hospital Essen; the Department of Internal Medicine (B.H.), Hospital Bremen Center; the Department of Hematology and Oncology (T.F.), University Hospital Magdeburg; the Department of Neurology (T.H.), University Hospital Mainz; the Department of Hematology and Oncology (H.G.M.), Klinikum Stuttgart; the Department of Hematology and Oncology (C.J.), University Hospital Rostock; the Department of Neurology (T.B.), University Hospital Munich LMU; the Departments of Neurology (U.H., P.R., M.W.) and Radiation Oncology (M.B.), University Hospital Tübingen; the Department of Neurology (U.H.), University Bonn, Germany; the Department of Neurology (P.R., M.W.), University Hospital Zurich, Switzerland; and the Institute of Neuropathology (T.P.), University Hospital Bonn, Germany.
  • Hertenstein B From the Department of Hematology, Oncology and Tumor Immunology (A.K., E.T., L.F., K.J.), Charité Berlin; the Departments of Clinical Epidemiology and Applied Biostatistics (P.M.) and Hematology and Oncology (R.M.), University Tübingen; the Department of Radiotherapy and Medical Oncology (F.G.), Pius Hospital Oldenburg; the Department of Neurology (M.R.), Protestant Hospital Bielefeld; the Department of Hematology (A.R.), University Hospital Essen; the Department of Internal Medicine (B.H.), Hospital Bremen Center; the Department of Hematology and Oncology (T.F.), University Hospital Magdeburg; the Department of Neurology (T.H.), University Hospital Mainz; the Department of Hematology and Oncology (H.G.M.), Klinikum Stuttgart; the Department of Hematology and Oncology (C.J.), University Hospital Rostock; the Department of Neurology (T.B.), University Hospital Munich LMU; the Departments of Neurology (U.H., P.R., M.W.) and Radiation Oncology (M.B.), University Hospital Tübingen; the Department of Neurology (U.H.), University Bonn, Germany; the Department of Neurology (P.R., M.W.), University Hospital Zurich, Switzerland; and the Institute of Neuropathology (T.P.), University Hospital Bonn, Germany.
  • Fischer T From the Department of Hematology, Oncology and Tumor Immunology (A.K., E.T., L.F., K.J.), Charité Berlin; the Departments of Clinical Epidemiology and Applied Biostatistics (P.M.) and Hematology and Oncology (R.M.), University Tübingen; the Department of Radiotherapy and Medical Oncology (F.G.), Pius Hospital Oldenburg; the Department of Neurology (M.R.), Protestant Hospital Bielefeld; the Department of Hematology (A.R.), University Hospital Essen; the Department of Internal Medicine (B.H.), Hospital Bremen Center; the Department of Hematology and Oncology (T.F.), University Hospital Magdeburg; the Department of Neurology (T.H.), University Hospital Mainz; the Department of Hematology and Oncology (H.G.M.), Klinikum Stuttgart; the Department of Hematology and Oncology (C.J.), University Hospital Rostock; the Department of Neurology (T.B.), University Hospital Munich LMU; the Departments of Neurology (U.H., P.R., M.W.) and Radiation Oncology (M.B.), University Hospital Tübingen; the Department of Neurology (U.H.), University Bonn, Germany; the Department of Neurology (P.R., M.W.), University Hospital Zurich, Switzerland; and the Institute of Neuropathology (T.P.), University Hospital Bonn, Germany.
  • Hundsberger T From the Department of Hematology, Oncology and Tumor Immunology (A.K., E.T., L.F., K.J.), Charité Berlin; the Departments of Clinical Epidemiology and Applied Biostatistics (P.M.) and Hematology and Oncology (R.M.), University Tübingen; the Department of Radiotherapy and Medical Oncology (F.G.), Pius Hospital Oldenburg; the Department of Neurology (M.R.), Protestant Hospital Bielefeld; the Department of Hematology (A.R.), University Hospital Essen; the Department of Internal Medicine (B.H.), Hospital Bremen Center; the Department of Hematology and Oncology (T.F.), University Hospital Magdeburg; the Department of Neurology (T.H.), University Hospital Mainz; the Department of Hematology and Oncology (H.G.M.), Klinikum Stuttgart; the Department of Hematology and Oncology (C.J.), University Hospital Rostock; the Department of Neurology (T.B.), University Hospital Munich LMU; the Departments of Neurology (U.H., P.R., M.W.) and Radiation Oncology (M.B.), University Hospital Tübingen; the Department of Neurology (U.H.), University Bonn, Germany; the Department of Neurology (P.R., M.W.), University Hospital Zurich, Switzerland; and the Institute of Neuropathology (T.P.), University Hospital Bonn, Germany.
  • Mergenthaler HG From the Department of Hematology, Oncology and Tumor Immunology (A.K., E.T., L.F., K.J.), Charité Berlin; the Departments of Clinical Epidemiology and Applied Biostatistics (P.M.) and Hematology and Oncology (R.M.), University Tübingen; the Department of Radiotherapy and Medical Oncology (F.G.), Pius Hospital Oldenburg; the Department of Neurology (M.R.), Protestant Hospital Bielefeld; the Department of Hematology (A.R.), University Hospital Essen; the Department of Internal Medicine (B.H.), Hospital Bremen Center; the Department of Hematology and Oncology (T.F.), University Hospital Magdeburg; the Department of Neurology (T.H.), University Hospital Mainz; the Department of Hematology and Oncology (H.G.M.), Klinikum Stuttgart; the Department of Hematology and Oncology (C.J.), University Hospital Rostock; the Department of Neurology (T.B.), University Hospital Munich LMU; the Departments of Neurology (U.H., P.R., M.W.) and Radiation Oncology (M.B.), University Hospital Tübingen; the Department of Neurology (U.H.), University Bonn, Germany; the Department of Neurology (P.R., M.W.), University Hospital Zurich, Switzerland; and the Institute of Neuropathology (T.P.), University Hospital Bonn, Germany.
  • Junghanß C From the Department of Hematology, Oncology and Tumor Immunology (A.K., E.T., L.F., K.J.), Charité Berlin; the Departments of Clinical Epidemiology and Applied Biostatistics (P.M.) and Hematology and Oncology (R.M.), University Tübingen; the Department of Radiotherapy and Medical Oncology (F.G.), Pius Hospital Oldenburg; the Department of Neurology (M.R.), Protestant Hospital Bielefeld; the Department of Hematology (A.R.), University Hospital Essen; the Department of Internal Medicine (B.H.), Hospital Bremen Center; the Department of Hematology and Oncology (T.F.), University Hospital Magdeburg; the Department of Neurology (T.H.), University Hospital Mainz; the Department of Hematology and Oncology (H.G.M.), Klinikum Stuttgart; the Department of Hematology and Oncology (C.J.), University Hospital Rostock; the Department of Neurology (T.B.), University Hospital Munich LMU; the Departments of Neurology (U.H., P.R., M.W.) and Radiation Oncology (M.B.), University Hospital Tübingen; the Department of Neurology (U.H.), University Bonn, Germany; the Department of Neurology (P.R., M.W.), University Hospital Zurich, Switzerland; and the Institute of Neuropathology (T.P.), University Hospital Bonn, Germany.
  • Birnbaum T From the Department of Hematology, Oncology and Tumor Immunology (A.K., E.T., L.F., K.J.), Charité Berlin; the Departments of Clinical Epidemiology and Applied Biostatistics (P.M.) and Hematology and Oncology (R.M.), University Tübingen; the Department of Radiotherapy and Medical Oncology (F.G.), Pius Hospital Oldenburg; the Department of Neurology (M.R.), Protestant Hospital Bielefeld; the Department of Hematology (A.R.), University Hospital Essen; the Department of Internal Medicine (B.H.), Hospital Bremen Center; the Department of Hematology and Oncology (T.F.), University Hospital Magdeburg; the Department of Neurology (T.H.), University Hospital Mainz; the Department of Hematology and Oncology (H.G.M.), Klinikum Stuttgart; the Department of Hematology and Oncology (C.J.), University Hospital Rostock; the Department of Neurology (T.B.), University Hospital Munich LMU; the Departments of Neurology (U.H., P.R., M.W.) and Radiation Oncology (M.B.), University Hospital Tübingen; the Department of Neurology (U.H.), University Bonn, Germany; the Department of Neurology (P.R., M.W.), University Hospital Zurich, Switzerland; and the Institute of Neuropathology (T.P.), University Hospital Bonn, Germany.
  • Fischer L From the Department of Hematology, Oncology and Tumor Immunology (A.K., E.T., L.F., K.J.), Charité Berlin; the Departments of Clinical Epidemiology and Applied Biostatistics (P.M.) and Hematology and Oncology (R.M.), University Tübingen; the Department of Radiotherapy and Medical Oncology (F.G.), Pius Hospital Oldenburg; the Department of Neurology (M.R.), Protestant Hospital Bielefeld; the Department of Hematology (A.R.), University Hospital Essen; the Department of Internal Medicine (B.H.), Hospital Bremen Center; the Department of Hematology and Oncology (T.F.), University Hospital Magdeburg; the Department of Neurology (T.H.), University Hospital Mainz; the Department of Hematology and Oncology (H.G.M.), Klinikum Stuttgart; the Department of Hematology and Oncology (C.J.), University Hospital Rostock; the Department of Neurology (T.B.), University Hospital Munich LMU; the Departments of Neurology (U.H., P.R., M.W.) and Radiation Oncology (M.B.), University Hospital Tübingen; the Department of Neurology (U.H.), University Bonn, Germany; the Department of Neurology (P.R., M.W.), University Hospital Zurich, Switzerland; and the Institute of Neuropathology (T.P.), University Hospital Bonn, Germany.
  • Jahnke K From the Department of Hematology, Oncology and Tumor Immunology (A.K., E.T., L.F., K.J.), Charité Berlin; the Departments of Clinical Epidemiology and Applied Biostatistics (P.M.) and Hematology and Oncology (R.M.), University Tübingen; the Department of Radiotherapy and Medical Oncology (F.G.), Pius Hospital Oldenburg; the Department of Neurology (M.R.), Protestant Hospital Bielefeld; the Department of Hematology (A.R.), University Hospital Essen; the Department of Internal Medicine (B.H.), Hospital Bremen Center; the Department of Hematology and Oncology (T.F.), University Hospital Magdeburg; the Department of Neurology (T.H.), University Hospital Mainz; the Department of Hematology and Oncology (H.G.M.), Klinikum Stuttgart; the Department of Hematology and Oncology (C.J.), University Hospital Rostock; the Department of Neurology (T.B.), University Hospital Munich LMU; the Departments of Neurology (U.H., P.R., M.W.) and Radiation Oncology (M.B.), University Hospital Tübingen; the Department of Neurology (U.H.), University Bonn, Germany; the Department of Neurology (P.R., M.W.), University Hospital Zurich, Switzerland; and the Institute of Neuropathology (T.P.), University Hospital Bonn, Germany.
  • Herrlinger U From the Department of Hematology, Oncology and Tumor Immunology (A.K., E.T., L.F., K.J.), Charité Berlin; the Departments of Clinical Epidemiology and Applied Biostatistics (P.M.) and Hematology and Oncology (R.M.), University Tübingen; the Department of Radiotherapy and Medical Oncology (F.G.), Pius Hospital Oldenburg; the Department of Neurology (M.R.), Protestant Hospital Bielefeld; the Department of Hematology (A.R.), University Hospital Essen; the Department of Internal Medicine (B.H.), Hospital Bremen Center; the Department of Hematology and Oncology (T.F.), University Hospital Magdeburg; the Department of Neurology (T.H.), University Hospital Mainz; the Department of Hematology and Oncology (H.G.M.), Klinikum Stuttgart; the Department of Hematology and Oncology (C.J.), University Hospital Rostock; the Department of Neurology (T.B.), University Hospital Munich LMU; the Departments of Neurology (U.H., P.R., M.W.) and Radiation Oncology (M.B.), University Hospital Tübingen; the Department of Neurology (U.H.), University Bonn, Germany; the Department of Neurology (P.R., M.W.), University Hospital Zurich, Switzerland; and the Institute of Neuropathology (T.P.), University Hospital Bonn, Germany.
  • Roth P From the Department of Hematology, Oncology and Tumor Immunology (A.K., E.T., L.F., K.J.), Charité Berlin; the Departments of Clinical Epidemiology and Applied Biostatistics (P.M.) and Hematology and Oncology (R.M.), University Tübingen; the Department of Radiotherapy and Medical Oncology (F.G.), Pius Hospital Oldenburg; the Department of Neurology (M.R.), Protestant Hospital Bielefeld; the Department of Hematology (A.R.), University Hospital Essen; the Department of Internal Medicine (B.H.), Hospital Bremen Center; the Department of Hematology and Oncology (T.F.), University Hospital Magdeburg; the Department of Neurology (T.H.), University Hospital Mainz; the Department of Hematology and Oncology (H.G.M.), Klinikum Stuttgart; the Department of Hematology and Oncology (C.J.), University Hospital Rostock; the Department of Neurology (T.B.), University Hospital Munich LMU; the Departments of Neurology (U.H., P.R., M.W.) and Radiation Oncology (M.B.), University Hospital Tübingen; the Department of Neurology (U.H.), University Bonn, Germany; the Department of Neurology (P.R., M.W.), University Hospital Zurich, Switzerland; and the Institute of Neuropathology (T.P.), University Hospital Bonn, Germany.
  • Bamberg M From the Department of Hematology, Oncology and Tumor Immunology (A.K., E.T., L.F., K.J.), Charité Berlin; the Departments of Clinical Epidemiology and Applied Biostatistics (P.M.) and Hematology and Oncology (R.M.), University Tübingen; the Department of Radiotherapy and Medical Oncology (F.G.), Pius Hospital Oldenburg; the Department of Neurology (M.R.), Protestant Hospital Bielefeld; the Department of Hematology (A.R.), University Hospital Essen; the Department of Internal Medicine (B.H.), Hospital Bremen Center; the Department of Hematology and Oncology (T.F.), University Hospital Magdeburg; the Department of Neurology (T.H.), University Hospital Mainz; the Department of Hematology and Oncology (H.G.M.), Klinikum Stuttgart; the Department of Hematology and Oncology (C.J.), University Hospital Rostock; the Department of Neurology (T.B.), University Hospital Munich LMU; the Departments of Neurology (U.H., P.R., M.W.) and Radiation Oncology (M.B.), University Hospital Tübingen; the Department of Neurology (U.H.), University Bonn, Germany; the Department of Neurology (P.R., M.W.), University Hospital Zurich, Switzerland; and the Institute of Neuropathology (T.P.), University Hospital Bonn, Germany.
  • Pietsch T From the Department of Hematology, Oncology and Tumor Immunology (A.K., E.T., L.F., K.J.), Charité Berlin; the Departments of Clinical Epidemiology and Applied Biostatistics (P.M.) and Hematology and Oncology (R.M.), University Tübingen; the Department of Radiotherapy and Medical Oncology (F.G.), Pius Hospital Oldenburg; the Department of Neurology (M.R.), Protestant Hospital Bielefeld; the Department of Hematology (A.R.), University Hospital Essen; the Department of Internal Medicine (B.H.), Hospital Bremen Center; the Department of Hematology and Oncology (T.F.), University Hospital Magdeburg; the Department of Neurology (T.H.), University Hospital Mainz; the Department of Hematology and Oncology (H.G.M.), Klinikum Stuttgart; the Department of Hematology and Oncology (C.J.), University Hospital Rostock; the Department of Neurology (T.B.), University Hospital Munich LMU; the Departments of Neurology (U.H., P.R., M.W.) and Radiation Oncology (M.B.), University Hospital Tübingen; the Department of Neurology (U.H.), University Bonn, Germany; the Department of Neurology (P.R., M.W.), University Hospital Zurich, Switzerland; and the Institute of Neuropathology (T.P.), University Hospital Bonn, Germany.
  • Weller M From the Department of Hematology, Oncology and Tumor Immunology (A.K., E.T., L.F., K.J.), Charité Berlin; the Departments of Clinical Epidemiology and Applied Biostatistics (P.M.) and Hematology and Oncology (R.M.), University Tübingen; the Department of Radiotherapy and Medical Oncology (F.G.), Pius Hospital Oldenburg; the Department of Neurology (M.R.), Protestant Hospital Bielefeld; the Department of Hematology (A.R.), University Hospital Essen; the Department of Internal Medicine (B.H.), Hospital Bremen Center; the Department of Hematology and Oncology (T.F.), University Hospital Magdeburg; the Department of Neurology (T.H.), University Hospital Mainz; the Department of Hematology and Oncology (H.G.M.), Klinikum Stuttgart; the Department of Hematology and Oncology (C.J.), University Hospital Rostock; the Department of Neurology (T.B.), University Hospital Munich LMU; the Departments of Neurology (U.H., P.R., M.W.) and Radiation Oncology (M.B.), University Hospital Tübingen; the Department of Neurology (U.H.), University Bonn, Germany; the Department of Neurology (P.R., M.W.), University Hospital Zurich, Switzerland; and the Institute of Neuropathology (T.P.), University Hospital Bonn, Germany.
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  • 2015-02-27
Published in:
  • Neurology. - 2015
Aged
Antimetabolites, Antineoplastic
Antineoplastic Protocols
Central Nervous System Neoplasms
Combined Modality Therapy
Cranial Irradiation
Disease-Free Survival
Humans
Lymphoma
Male
Methotrexate
Middle Aged
Treatment Outcome
English OBJECTIVE
This is the final report of a phase III randomized study to evaluate whole-brain radiotherapy (WBRT) in primary therapy of primary CNS lymphoma (PCNSL) after a median follow-up of 81.2 months.


METHODS
Patients with newly diagnosed PCNSL were randomized to high-dose methotrexate (HDMTX)-based chemotherapy alone or followed by WBRT. We hypothesized that the omission of WBRT would not compromise overall survival (OS; primary endpoint), using a noninferiority design with a margin of 0.9.


RESULTS
In the per-protocol population (n = 320), WBRT nonsignificantly prolonged progression-free survival (PFS) (median 18.2 vs 11.9 months, hazard ratio [HR] 0.83 [95% confidence interval (CI) 0.65-1.06], p = 0.14) and significantly PFS from last HDMTX (25.5 vs 12.0 months, HR 0.65 [95% CI 0.5-0.83], p = 0.001), but without OS prolongation (35.6 vs 37.1 months, HR 1.03 [95% CI 0.79-1.35], p = 0.82). In the intent-to-treat population (n = 410), there was a prolongation by WBRT of both PFS (15.4 vs 9.9 months, HR 0.79 [95% CI 0.64-0.98], p = 0.034) and PFS from last HDMTX (19.4 vs 11.9 months, HR 0.72 [95% CI 0.58-0.89], p = 0.003), but not of OS (32.4 vs 36.1 months, HR 0.98 [95% CI 0.79-1.26], p = 0.98).


CONCLUSION
Although the statistical proof of noninferiority regarding OS was not given, our results suggest no worsening of OS without WBRT in primary therapy of PCNSL.


CLASSIFICATION OF EVIDENCE
This study provides Class II evidence that in PCNSL HDMTX-based chemotherapy followed by WBRT does not significantly increase survival compared to chemotherapy alone. The study lacked the precision to exclude an important survival benefit or harm from WBRT.
Language
  • English
Open access status
green
Identifiers
Persistent URL
https://folia.unifr.ch/global/documents/96635
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