Comment [In Primary CNS lymphoma in immunocompetent patients from 1989 to 2001: a retrospective analysis of 164 cases uniformly diagnosed by stereotactic biopsy p.838]
Comment [In Primary CNS lymphoma in immunocompetent patients from 1989 to 2001: a retrospective analysis of 164 cases uniformly diagnosed by stereotactic biopsy p.838]
Background. We present outcome data of a cohort of 164 immunocompetent PCNSL patients uniformly diagnosed at a single center for stereotactic neurosurgery, and evaluate the acceptance and impact of combination radiotherapy (RT) and chemotherapy (CHT) with high-dose methotrexate (HD-MTX) over time.
Method. We assessed choice of treatment and patient survival in a series of 164 PCNSL cases diagnosed from 1989 to 2001, and performed a re-evaluation of histopathology and pre-operative clinical data. Findings. From 1989 to 1993, RT was the predominant therapy, and additional CHT did not improve survival. After 1994, the use of combination CHT=RT increased continuously, consistently contained MTX, and was associated with longer survival than RT only: median survival was 14 months after CHT=RT (2-year survival 35.7%) and 10 months (2-year survival 26.2%) after RT only (not significant). Overall median survival remained poor, increasing from six (1989–1993) to nine months (1994–2001) (p=0.008). Survival was variable, with a few patients surviving>4 years after diagnosis in the CHT=RT as well as in the RT only group.
Conclusions. Despite considerable improvement of PCNSL therapy, the overall benefit of combined CHT=RT versus RT only was lower than that expected from previous phase II clinical trials. The striking variability of survival in either treatment group may suggest a yet undefined biological heterogeneity of PCNSL, which may also include a more aggressive PCNSL subtype in the group of patients with rapidly progressive disease and not eligible for standard therapy.
primary CNS lymphoma, combined therapy, clinicaloutcome, diagnosis, stereotactic brain biopsy
831-838
Weller, R.O.
4a501831-e38a-4d39-a125-d7141d6c667b
2006
Weller, R.O.
4a501831-e38a-4d39-a125-d7141d6c667b
Weller, R.O.
(2006)
Comment [In Primary CNS lymphoma in immunocompetent patients from 1989 to 2001: a retrospective analysis of 164 cases uniformly diagnosed by stereotactic biopsy p.838].
Acta Neurochirurgica, 148 (8), .
(doi:10.1007/s00701-006-0790-9).
Abstract
Background. We present outcome data of a cohort of 164 immunocompetent PCNSL patients uniformly diagnosed at a single center for stereotactic neurosurgery, and evaluate the acceptance and impact of combination radiotherapy (RT) and chemotherapy (CHT) with high-dose methotrexate (HD-MTX) over time.
Method. We assessed choice of treatment and patient survival in a series of 164 PCNSL cases diagnosed from 1989 to 2001, and performed a re-evaluation of histopathology and pre-operative clinical data. Findings. From 1989 to 1993, RT was the predominant therapy, and additional CHT did not improve survival. After 1994, the use of combination CHT=RT increased continuously, consistently contained MTX, and was associated with longer survival than RT only: median survival was 14 months after CHT=RT (2-year survival 35.7%) and 10 months (2-year survival 26.2%) after RT only (not significant). Overall median survival remained poor, increasing from six (1989–1993) to nine months (1994–2001) (p=0.008). Survival was variable, with a few patients surviving>4 years after diagnosis in the CHT=RT as well as in the RT only group.
Conclusions. Despite considerable improvement of PCNSL therapy, the overall benefit of combined CHT=RT versus RT only was lower than that expected from previous phase II clinical trials. The striking variability of survival in either treatment group may suggest a yet undefined biological heterogeneity of PCNSL, which may also include a more aggressive PCNSL subtype in the group of patients with rapidly progressive disease and not eligible for standard therapy.
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Published date: 2006
Keywords:
primary CNS lymphoma, combined therapy, clinicaloutcome, diagnosis, stereotactic brain biopsy
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Local EPrints ID: 62643
URI: http://eprints.soton.ac.uk/id/eprint/62643
ISSN: 0001-6268
PURE UUID: ee9b0976-90ce-4f63-bf4d-b4a8dcdc9ccd
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Date deposited: 02 Sep 2008
Last modified: 15 Mar 2024 11:31
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R.O. Weller
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