High-Dose Chemo Helps Beat Rare Brain Cancer

Mar. 23 -- WEDNESDAY, Jan. 30 (HealthDay News) -- Most people suffering from a rare brain cancer appear to benefit from high doses of the chemotherapy drug methotrexate, a small study finds.

Primary central nervous system lymphoma (PCNSL) is a type of non-Hodgkin lymphoma that affects the brain. Although it is typically very difficult to treat, it can be cured or sent into long remissions. Current treatment is often a combination of radiation and chemotherapy. Newer approaches involve giving chemotherapy first, and waiting on radiation until the results of chemotherapy are seen.

However, "A subset of these patients with a rare form of non-Hodgkin lymphoma appeared to be cured by chemotherapy alone," explained lead researcher Dr. Tracy Batchelor, from the Massachusetts General Hospital Cancer Center in Boston.

Batchelor, who is executive director of the Stephen E. & Catherine Pappas Center for Neuro-Oncology at the hospital, noted there are about 1,500 new cases of PCNSL diagnosed in the United States each year.

In the study, Batchelor's group treated 25 adults with newly diagnosed PCNSL with a high dose of methotrexate every two weeks for four months, or until there were no signs of the brain tumor. The patients were followed for a minimum of 6.5 years.

The report appears in the Jan. 29 issue of Neurology.

Batchelor's team found that 52 percent of the patients had a complete remission of their cancer and 40 percent had not had a relapse after seven years. Average survival of all patients who received methotrexate was 4.5 years, compared with one year among patients who had radiation therapy.

It's clear that methotrexate is the best drug to treat this tumor, Batchelor said. "The drug attacks cells that are dividing. Other drugs don't have as high a response rate," he explained.

Batchelor noted that it is unusual for a single drug to achieve remission in cancer.

More studies are needed to find the most effective dose of methotrexate and to find a combination therapy that will produce even better results, Batchelor said. "The question is whether adding other drugs will make patients do better," he said.