{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T06:10:02Z","timestamp":1791007802271,"version":"4.1.0"},"reference-count":46,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"21","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2009,7,20]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> Primary CNS lymphoma (PCNSL) is confined to the CNS and\/or the eyes at presentation and is usually initially treated with intravenous methotrexate-based chemotherapy and whole-brain radiotherapy (WBRT). However, the intact blood-brain barrier (BBB) can limit diffusion of methotrexate into brain and tumor. With BBB disruption (BBBD), enhanced drug delivery to the tumor can be achieved. <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> This report summarizes the multi-institutional experience of 149 newly diagnosed (with no prior WBRT) patients with PCNSL treated with osmotic BBBD and intra-arterial (IA) methotrexate at four institutions from 1982 to 2005. In this series, 47.6% of patients were age \u2265 60 years, and 42.3% had Karnofsky performance score (KPS) less than 70 at diagnosis. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> The overall response rate was 81.9% (57.8% complete; 24.2% partial). Median overall survival (OS) was 3.1 years (25% estimated survival at 8.5 years). Median progression-free survival (PFS) was 1.8 years, with 5-year PFS of 31% and 7-year PFS of 25%. In low-risk patients (age &lt; 60 years and KPS \u2265 70), median OS was approximately 14 years, with a plateau after approximately 8 years. Procedures were generally well tolerated; focal seizures (9.2%) were the most frequent side effect and lacked long-term sequelae. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> This large series of patients treated over a 23-year period demonstrates that BBBD\/IA methotrexate-based chemotherapy results in successful and durable tumor control and outcomes that are comparable or superior to other PCNSL treatment regimens. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2008.19.3789","type":"journal-article","created":{"date-parts":[[2009,5,19]],"date-time":"2009-05-19T01:47:03Z","timestamp":1242697623000},"page":"3503-3509","source":"Crossref","is-referenced-by-count":206,"title":["Blood-Brain Barrier Disruption and Intra-Arterial Methotrexate-Based Therapy for Newly Diagnosed Primary CNS Lymphoma: A Multi-Institutional Experience"],"prefix":"10.1200","volume":"27","author":[{"given":"Lilyana","family":"Angelov","sequence":"first","affiliation":[{"name":"From the Brain Tumor and Neuro-Oncology Center and Departments of Neurosurgery and Hematology and Medical Oncology, Cleveland Clinic, Cleveland; Department of Neurosurgery, Ohio State University Medical Center, Columbus, OH; Departments of Neurology, Public Health and Preventive Medicine, Department of Medical Informatics and Clinical Epidemiology, Medicine, and Neurosurgery, Oregon Health & Science University; Department of Pharmacy Practice, Oregon State University; Portland Veterans Affairs Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy D.","family":"Doolittle","sequence":"additional","affiliation":[{"name":"From the Brain Tumor and Neuro-Oncology Center and Departments of Neurosurgery and Hematology and Medical Oncology, Cleveland Clinic, Cleveland; Department of Neurosurgery, Ohio State University Medical Center, Columbus, OH; Departments of Neurology, Public Health and Preventive Medicine, Department of Medical Informatics and Clinical Epidemiology, 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