J Korean Soc Ther Radiol.  1995 Dec;13(4):385-390.

The CNS Relapse of the Acute Lymphoblastic Leukemia: Radiotherapy Results

• Kim YH
• Kim IH

Abstract

PURPOSE: To assess the efficacy of craniospinal radiotherapy in patients with acute lymphoblastic leukemia (ALL) experiencing the CNS relapse.
MATERIALS AND METHODS
Thirty ALL patients with relapse in the central nervous system(CNS) were treated with radiotherapy and intrathecal chemotherapy. Age ranged 2 to 46. The number of males and females were all 15. Twenty-two cases were previously treated with presymptomatic radiotherapy to the whole brain. The extent of radiotherapy was the whole brain (18-24 Gy) and the whole spine (12 Gy) in 21 cases but the whole brain only in the 9 cases with poor performance.
RESULTS
The complete remission rate in the CNS was 10%. Among the 12 cases(40%) who had secondary relapse, 9 cases had the bone marrow relapse alone, 2 cases had the CNS and bone marrow relapse, 1 case had the CNS relapse alone. Higher CNS remission rate was observed when the initial remission duration was longer than 24 months or radiation was delivered to the whole brain and the whole spine. Survival rate at 2 year was 31.6%. Remission duration in the 10 living patients ranged from 9 to 87 months(median ; 58 months).
CONCLUSION
The whole craniospinal area should be included in the radiotherapy port for the effective control of CNS relapse in ALL cases

Keyword

Acute lymphoblastic leukemia; Central nervous system relapse; Craniospinal irradiation

MeSH Terms

Bone Marrow
Brain
Craniospinal Irradiation
Drug Therapy
Female
Humans
Male
Precursor Cell Lymphoblastic Leukemia-Lymphoma*
Radiotherapy*
Recurrence*
Spine
Survival Rate