J Korean Med Sci.  1999 Oct;14(5):565-570. 10.3346/jkms.1999.14.5.565.

Survival improvement with combined radio-chemotherapy in the primary central nervous system lymphomas

• Wu HG
• Kim IH
• Ha SW
• Park CI
• Bang YJ
• Huh DS

• KMID: 646026
• DOI: http://doi.org/10.3346/jkms.1999.14.5.565

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.

Keyword

Radiotherapy; Drug therapy; Lymphoma; Central nervous system

MeSH Terms

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