Outcome of Primary Central Nervous System Lymphoma Treated with Combined Surgical Resection and High-Dose Methotrexate Chemotherapy: A Single-Institution Retrospective Study

AIM: To evaluate the feasibility and long-term clinical results of combined surgical resection and high-dose methotrexate (HD-MTX) chemotherapy for primary central nervous system lymphoma (PCNSL) of the brain. MATERIAL and METHODS: Fifty-eight patients were diagnosed with PCNSL by histopathological examination of brain biopsy specimens at the Second Affiliated Hospital of Bengbu Medical College from March 2013 to December 2017. All patients received MTX at adose of 3.5 g/m2 every 2 weeks for 6 cycles. Clinical information, including ages, number of lesions, and tumor locations, were retrospectively collected from the medical records. RESULTS: The complete remission rates in patients treated with MTX plus craniotomy for surgical resection and those treated with MTX alone were 70.0% and 32.1%, respectively (p=0.021). Adding craniotomy to MTX chemotherapy did not increase the complication rate. The most common adverse events were hematological toxicity, liver toxicity, and gastrointestinal reaction were similar between groups. Multivariate analysis showed that surgical resection was associated with longer progression-free survival (PFS) (OR: p=0.002), CONCLUSION: Combining craniotomy for surgical resection and MTX-based chemotherapy may be safe and effective for treating PCNSL.