Survival improvement with combined radio-chemotherapy in the primary central nervous system lymphomas.
10.3346/jkms.1999.14.5.565
- Author:
Hong Gyun WU
1
;
Il Han KIM
;
Sung Whan HA
;
Charn Il PARK
;
Young Joo BANG
;
Dae Seok HUH
Author Information
1. Department of Therapeutic Radiology, Seoul National University College of Medicine, Korea.
- Publication Type:Original Article ; Clinical Trial ; Research Support, Non-U.S. Gov't
- Keywords:
Radiotherapy;
Drug therapy;
Lymphoma;
Central nervous system
- MeSH:
Adolescence;
Adult;
Aged;
Antineoplastic Agents, Combined/therapeutic use*;
Antineoplastic Agents, Combined/adverse effects;
Bleomycin/administration & dosage;
Central Nervous System Neoplasms/therapy*;
Central Nervous System Neoplasms/mortality;
Cyclophosphamide/administration & dosage;
Disease-Free Survival;
Doxorubicin/administration & dosage;
Epirubicin/administration & dosage;
Female;
Human;
Lymphoma/therapy*;
Lymphoma/mortality;
Male;
Mechlorethamine/administration & dosage;
Methotrexate/administration & dosage;
Middle Age;
Neoplasm Recurrence, Local;
Prednisolone/administration & dosage;
Procarbazine/administration & dosage;
Radiotherapy Dosage;
Radiotherapy, Adjuvant/adverse effects;
Survival Rate;
Treatment Failure;
Vincristine/administration & dosage
- From:Journal of Korean Medical Science
1999;14(5):565-570
- CountryRepublic of Korea
- Language:English
-
Abstract:
The benefits of radio-chemotherapy in HIV-negative primary central nervous system (CNS) lymphomas were analyzed in 40 patients, who received radiotherapy to the brain or craniospinal axis with the total dose of 4460-5940 cGy to the primary tumor. Radiotherapy was followed by systemic chemotherapy, mainly with the cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP) regimen, in 16 of the patients. Follow-up ranged from four to 95 months with a median of 15 months. The relapse rate was 72.5%, and 83% of the relapses occurred within the radiation field. Median survival was 19 months and the two-year survival rate was 41%. Survival was significantly influenced by treatment method and radiation dose when measured by univariate analysis; median survival and the two-year survival rate was 29 months and 63% after radio-chemotherapy, while 13.5 month and 29% after radiotherapy alone (p= 0.027), and 22 months and 49% with doses of 50 Gy or more, but 12.5 months and 13% with doses less than 50 Gy (p=0.009). However, statistical significance was lost in multivariate analysis. These results might suggest the short-term efficacy of radio-chemotherapy, however, cautious observation is needed to confirm long-term effects.
