{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:05:48Z","timestamp":1777878348051,"version":"3.51.4"},"reference-count":35,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"The Thai Society of Hematology"},{"DOI":"10.13039\/501100004776","name":"faculty of medicine, chulalongkorn university","doi-asserted-by":"publisher","award":["GA67\/023"],"award-info":[{"award-number":["GA67\/023"]}],"id":[{"id":"10.13039\/501100004776","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Hematology"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Outcomes for primary central nervous system lymphoma (PCNSL) have been improved with high-dose methotrexate (HD-MTX)\/Thiotepa-based chemotherapy followed by autologous stem cell transplantation. In limited-resource settings, HD-MTX\/Ifosfamide plus whole brain radiotherapy (WBRT) has become the local standard of care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study investigated the real-world effectiveness, neurocognitive functions, and health-related quality of life (HRQoL) of HD-MTX\/Ifosfamide in newly diagnosed PCNSL patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A single-center retrospective and prospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Newly diagnosed PCNSL patients treated with HD-MTX (\u00b1Ifosfamide) between 2011 and 2024 were analyzed for treatment effectiveness using binary logistic regression and a Cox regression model. The age range- and education-matched PCNSL and non-central nervous system (CNS) lymphoma patients in first remission were assessed using standardized cognitive tests and European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30\/BN20 questionnaires. The categorical data and continuous data were calculated with the Chi-square test or Fisher\u2019s exact test and analysis of variance, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 94 PCNSL patients, 56 patients received HD-MTX\/Ifosfamide (median age 56 (range 16\u201369)\u2009years; 68% Eastern Cooperative Oncology Group (ECOG) 0\u20131) and 38 patients received HD-MTX monotherapy (median age 66 (range 51\u201382)\u2009years; 63% ECOG \u2a7e2). HD-MTX\/Ifosfamide demonstrated a significantly longer event-free survival (39\u2009months vs 8\u2009months,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.021) than HD-MTX monotherapy. Poor performance status (ECOG \u2a7e2) was associated with inferior response (54.8% vs 78.8%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.013) and overall survival (hazard ratio 2.4 (95% confidence interval 1.57\u20134.56),\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.007). Patients who received WBRT consolidation had a superior 2-year progression-free survival (74.5% vs 35.6%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Comparing neurocognitive tests in 20 PCNSL and 20 non-CNS lymphoma survivors showed no difference in overall scores, but trends toward lower attention and executive function scores in the PCNSL group. Most (16\/20) PCNSL survivors received WBRT. Compared to non-CNS lymphoma survivors, PCNSL survivors reported significantly lower HRQoL, particularly in physical functioning, which might be attributed to residual neurological deficits.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study supports HD-MTX\/Ifosfamide as an effective, well-tolerated regimen for younger, fit PCNSL patients. WBRT remains a valuable consolidation therapy to prevent recurrence without a pronounced decline in cognitive function. However, PCNSL survivors may experience subtle declines in attention, executive function, and HRQoL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20406207251400429","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T05:12:07Z","timestamp":1765775527000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-world survival, cognitive, and quality of life outcomes of methotrexate\/ifosfamide plus whole brain radiotherapy for newly diagnosed primary central nervous system lymphoma"],"prefix":"10.1177","volume":"16","author":[{"given":"Warayoot","family":"Luangmaneerote","sequence":"first","affiliation":[{"name":"Division of Hematology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand"},{"name":"Center of Excellence in Translational Hematology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natrada","family":"Rattanapong","sequence":"additional","affiliation":[{"name":"Cognitive Clinical and Computational Neuroscience Center of Excellence, King Chulalongkorn Memorial Hospital, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthipa","family":"Chokesuwattanaskul","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tassapong","family":"Raiyawa","sequence":"additional","affiliation":[{"name":"Department of Radiology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thunyamon","family":"Chajuwan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Sunprasitthiprasong Hospital, Ubon Ratchathani, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pitchayaporn","family":"Jongdee","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surin Hospital, Surin, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ponlapat","family":"Rojnuckarin","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand"},{"name":"Center of Excellence in Translational Hematology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5258-2140","authenticated-orcid":false,"given":"Chantiya","family":"Chanswangphuwana","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Rama IV Road, Patumwan, Bangkok 10330, Thailand"},{"name":"Center of Excellence in Translational Hematology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,14]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.72.7602"},{"key":"e_1_3_4_3_2","volume-title":"World health organization classification of tumours of haematopoietic and lymphoid tissues","author":"Swerdlow SH","year":"2017","unstructured":"Swerdlow SH, Campo E, Harris NJ, et al., eds. 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