Results of radiation monotherapy for primary central nervous system lymphoma in the 1990s
Purpose: Results of radiation therapy for primary central nervous system lymphoma (PCNSL) were poor in the 1970–1980s, with most reported 5-year survival rates being less than 10%. To investigate whether the prognosis of PCNSL patients treated by radiation alone remains still poor, we investigated t...
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Published in | International journal of radiation oncology, biology, physics Vol. 62; no. 3; pp. 809 - 813 |
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Main Authors | , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Elsevier Inc
01.07.2005
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Subjects | |
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Abstract | Purpose: Results of radiation therapy for primary central nervous system lymphoma (PCNSL) were poor in the 1970–1980s, with most reported 5-year survival rates being less than 10%. To investigate whether the prognosis of PCNSL patients treated by radiation alone remains still poor, we investigated the results of radiation monotherapy in the 1990s.
Methods and Materials: We collected data on 132 patients with histologically proven PCNSL treated by radiation alone in the 1990s from three nationwide or regional multiinstitutional studies conducted by the Japanese Society for Therapeutic Radiology and Oncology (JASTRO) Lymphoma Study Group or the Chubu Radiation Oncology Group. Follow-up data were updated as far as possible. Eleven patients who did not complete planned radiotherapy were included. The data were analyzed in relation to patient and tumor characteristics. The median patient age was 63 years, and the World Health Organization performance status (PS) was 3 or 4 in 40% of the patients. Multiple tumors were seen in 34%. Whole-brain irradiation with or without focal boost was used in 92%. The median radiation dose to the tumor site was 50 Gy (range, 8–74 Gy).
Results: For all 132 patients, the median survival time was 18 months and the 5-year survival rate was 18.0%. For 62 patients with PS 0–3 and aged 16–65 years (i.e., those eligible for the European Organization for Research and Treatment of Cancer 20962 study), the median survival was 26 months and 5-year survival was 24%. The 5-year survival was 25% for patients 63 years old or younger, and 9.8% for those older than 63 years (
p = 0.0005). The 5-year survival was 22% for patients with PS 0–2 and 13% for those with PS 3 or 4 (
p = 0.0040). Multivariate analysis confirmed the negative influence of higher age on patient prognosis.
Conclusions: The results of radiation monotherapy for PCNSL appear to have improved as compared with those reported previously. The results of new treatment should be evaluated in light of this finding. Since most prospective studies on the combined treatment exclude poor PS and high-age patients, the 5-year survival rate of 30% may not be regarded as a marked improvement over radiation alone. |
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AbstractList | Purpose: Results of radiation therapy for primary central nervous system lymphoma (PCNSL) were poor in the 1970-1980s, with most reported 5-year survival rates being less than 10%. To investigate whether the prognosis of PCNSL patients treated by radiation alone remains still poor, we investigated the results of radiation monotherapy in the 1990s. Methods and Materials: We collected data on 132 patients with histologically proven PCNSL treated by radiation alone in the 1990s from three nationwide or regional multiinstitutional studies conducted by the Japanese Society for Therapeutic Radiology and Oncology (JASTRO) Lymphoma Study Group or the Chubu Radiation Oncology Group. Follow-up data were updated as far as possible. Eleven patients who did not complete planned radiotherapy were included. The data were analyzed in relation to patient and tumor characteristics. The median patient age was 63 years, and the World Health Organization performance status (PS) was 3 or 4 in 40% of the patients. Multiple tumors were seen in 34%. Whole-brain irradiation with or without focal boost was used in 92%. The median radiation dose to the tumor site was 50 Gy (range, 8-74 Gy). Results: For all 132 patients, the median survival time was 18 months and the 5-year survival rate was 18.0%. For 62 patients with PS 0-3 and aged 16-65 years (i.e., those eligible for the European Organization for Research and Treatment of Cancer 20962 study), the median survival was 26 months and 5-year survival was 24%. The 5-year survival was 25% for patients 63 years old or younger, and 9.8% for those older than 63 years (p = 0.0005). The 5-year survival was 22% for patients with PS 0-2 and 13% for those with PS 3 or 4 (p = 0.0040). Multivariate analysis confirmed the negative influence of higher age on patient prognosis. Conclusions: The results of radiation monotherapy for PCNSL appear to have improved as compared with those reported previously. The results of new treatment should be evaluated in light of this finding. Since most prospective studies on the combined treatment exclude poor PS and high-age patients, the 5-year survival rate of 30% may not be regarded as a marked improvement over radiation alone. PURPOSEResults of radiation therapy for primary central nervous system lymphoma (PCNSL) were poor in the 1970-1980s, with most reported 5-year survival rates being less than 10%. To investigate whether the prognosis of PCNSL patients treated by radiation alone remains still poor, we investigated the results of radiation monotherapy in the 1990s.METHODS AND MATERIALSWe collected data on 132 patients with histologically proven PCNSL treated by radiation alone in the 1990s from three nationwide or regional multiinstitutional studies conducted by the Japanese Society for Therapeutic Radiology and Oncology (JASTRO) Lymphoma Study Group or the Chubu Radiation Oncology Group. Follow-up data were updated as far as possible. Eleven patients who did not complete planned radiotherapy were included. The data were analyzed in relation to patient and tumor characteristics. The median patient age was 63 years, and the World Health Organization performance status (PS) was 3 or 4 in 40% of the patients. Multiple tumors were seen in 34%. Whole-brain irradiation with or without focal boost was used in 92%. The median radiation dose to the tumor site was 50 Gy (range, 8-74 Gy).RESULTSFor all 132 patients, the median survival time was 18 months and the 5-year survival rate was 18.0%. For 62 patients with PS 0-3 and aged 16-65 years (i.e., those eligible for the European Organization for Research and Treatment of Cancer 20962 study), the median survival was 26 months and 5-year survival was 24%. The 5-year survival was 25% for patients 63 years old or younger, and 9.8% for those older than 63 years (p = 0.0005). The 5-year survival was 22% for patients with PS 0-2 and 13% for those with PS 3 or 4 (p = 0.0040). Multivariate analysis confirmed the negative influence of higher age on patient prognosis.CONCLUSIONSThe results of radiation monotherapy for PCNSL appear to have improved as compared with those reported previously. The results of new treatment should be evaluated in light of this finding. Since most prospective studies on the combined treatment exclude poor PS and high-age patients, the 5-year survival rate of 30% may not be regarded as a marked improvement over radiation alone. Results of radiation therapy for primary central nervous system lymphoma (PCNSL) were poor in the 1970-1980s, with most reported 5-year survival rates being less than 10%. To investigate whether the prognosis of PCNSL patients treated by radiation alone remains still poor, we investigated the results of radiation monotherapy in the 1990s. We collected data on 132 patients with histologically proven PCNSL treated by radiation alone in the 1990s from three nationwide or regional multiinstitutional studies conducted by the Japanese Society for Therapeutic Radiology and Oncology (JASTRO) Lymphoma Study Group or the Chubu Radiation Oncology Group. Follow-up data were updated as far as possible. Eleven patients who did not complete planned radiotherapy were included. The data were analyzed in relation to patient and tumor characteristics. The median patient age was 63 years, and the World Health Organization performance status (PS) was 3 or 4 in 40% of the patients. Multiple tumors were seen in 34%. Whole-brain irradiation with or without focal boost was used in 92%. The median radiation dose to the tumor site was 50 Gy (range, 8-74 Gy). For all 132 patients, the median survival time was 18 months and the 5-year survival rate was 18.0%. For 62 patients with PS 0-3 and aged 16-65 years (i.e., those eligible for the European Organization for Research and Treatment of Cancer 20962 study), the median survival was 26 months and 5-year survival was 24%. The 5-year survival was 25% for patients 63 years old or younger, and 9.8% for those older than 63 years (p = 0.0005). The 5-year survival was 22% for patients with PS 0-2 and 13% for those with PS 3 or 4 (p = 0.0040). Multivariate analysis confirmed the negative influence of higher age on patient prognosis. The results of radiation monotherapy for PCNSL appear to have improved as compared with those reported previously. The results of new treatment should be evaluated in light of this finding. Since most prospective studies on the combined treatment exclude poor PS and high-age patients, the 5-year survival rate of 30% may not be regarded as a marked improvement over radiation alone. Purpose: Results of radiation therapy for primary central nervous system lymphoma (PCNSL) were poor in the 1970–1980s, with most reported 5-year survival rates being less than 10%. To investigate whether the prognosis of PCNSL patients treated by radiation alone remains still poor, we investigated the results of radiation monotherapy in the 1990s. Methods and Materials: We collected data on 132 patients with histologically proven PCNSL treated by radiation alone in the 1990s from three nationwide or regional multiinstitutional studies conducted by the Japanese Society for Therapeutic Radiology and Oncology (JASTRO) Lymphoma Study Group or the Chubu Radiation Oncology Group. Follow-up data were updated as far as possible. Eleven patients who did not complete planned radiotherapy were included. The data were analyzed in relation to patient and tumor characteristics. The median patient age was 63 years, and the World Health Organization performance status (PS) was 3 or 4 in 40% of the patients. Multiple tumors were seen in 34%. Whole-brain irradiation with or without focal boost was used in 92%. The median radiation dose to the tumor site was 50 Gy (range, 8–74 Gy). Results: For all 132 patients, the median survival time was 18 months and the 5-year survival rate was 18.0%. For 62 patients with PS 0–3 and aged 16–65 years (i.e., those eligible for the European Organization for Research and Treatment of Cancer 20962 study), the median survival was 26 months and 5-year survival was 24%. The 5-year survival was 25% for patients 63 years old or younger, and 9.8% for those older than 63 years ( p = 0.0005). The 5-year survival was 22% for patients with PS 0–2 and 13% for those with PS 3 or 4 ( p = 0.0040). Multivariate analysis confirmed the negative influence of higher age on patient prognosis. Conclusions: The results of radiation monotherapy for PCNSL appear to have improved as compared with those reported previously. The results of new treatment should be evaluated in light of this finding. Since most prospective studies on the combined treatment exclude poor PS and high-age patients, the 5-year survival rate of 30% may not be regarded as a marked improvement over radiation alone. |
Author | Hasegawa, Masatoshi Nishio, Masamichi Suzuki, Kazunori Sougawa, Mitsuharu Ogino, Hiroyuki Kawamura, Toshiki Ishihara, Shun-Ichi Kenjo, Masahiro Fujii, Takashi Kato, Eriko Hayabuchi, Naofumi Shibamoto, Yuta |
Author_xml | – sequence: 1 givenname: Yuta surname: Shibamoto fullname: Shibamoto, Yuta email: yshiba@med.nagoya-cu.ac.jp organization: Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan – sequence: 2 givenname: Hiroyuki surname: Ogino fullname: Ogino, Hiroyuki organization: Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan – sequence: 3 givenname: Masatoshi surname: Hasegawa fullname: Hasegawa, Masatoshi organization: Japanese Society for Therapeutic Radiology and Oncology Lymphoma Study Group, Nagoya, Japan – sequence: 4 givenname: Kazunori surname: Suzuki fullname: Suzuki, Kazunori organization: Chubu Radiation Oncology Group, Nagoya, Japan – sequence: 5 givenname: Masamichi surname: Nishio fullname: Nishio, Masamichi organization: Japanese Society for Therapeutic Radiology and Oncology Lymphoma Study Group, Nagoya, Japan – sequence: 6 givenname: Takashi surname: Fujii fullname: Fujii, Takashi organization: Japanese Society for Therapeutic Radiology and Oncology Lymphoma Study Group, Nagoya, Japan – sequence: 7 givenname: Eriko surname: Kato fullname: Kato, Eriko organization: Chubu Radiation Oncology Group, Nagoya, Japan – sequence: 8 givenname: Shun-Ichi surname: Ishihara fullname: Ishihara, Shun-Ichi organization: Chubu Radiation Oncology Group, Nagoya, Japan – sequence: 9 givenname: Mitsuharu surname: Sougawa fullname: Sougawa, Mitsuharu organization: Japanese Society for Therapeutic Radiology and Oncology Lymphoma Study Group, Nagoya, Japan – sequence: 10 givenname: Masahiro surname: Kenjo fullname: Kenjo, Masahiro organization: Japanese Society for Therapeutic Radiology and Oncology Lymphoma Study Group, Nagoya, Japan – sequence: 11 givenname: Toshiki surname: Kawamura fullname: Kawamura, Toshiki organization: Chubu Radiation Oncology Group, Nagoya, Japan – sequence: 12 givenname: Naofumi surname: Hayabuchi fullname: Hayabuchi, Naofumi organization: Japanese Society for Therapeutic Radiology and Oncology Lymphoma Study Group, Nagoya, Japan |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/15936564$$D View this record in MEDLINE/PubMed |
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Keywords | Primary central nervous system lymphoma PCNSL Radiation therapy Brain neoplasm |
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Snippet | Purpose: Results of radiation therapy for primary central nervous system lymphoma (PCNSL) were poor in the 1970–1980s, with most reported 5-year survival rates... Results of radiation therapy for primary central nervous system lymphoma (PCNSL) were poor in the 1970-1980s, with most reported 5-year survival rates being... Purpose: Results of radiation therapy for primary central nervous system lymphoma (PCNSL) were poor in the 1970-1980s, with most reported 5-year survival rates... PURPOSEResults of radiation therapy for primary central nervous system lymphoma (PCNSL) were poor in the 1970-1980s, with most reported 5-year survival rates... |
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SubjectTerms | Adolescent Adult Aged Aged, 80 and over Brain neoplasm Central Nervous System Neoplasms - mortality Central Nervous System Neoplasms - radiotherapy Child Child, Preschool Female Humans Lymphoma - mortality Lymphoma - radiotherapy Male Middle Aged Multivariate Analysis PCNSL Primary central nervous system lymphoma Radiation therapy Survival Rate - trends |
Title | Results of radiation monotherapy for primary central nervous system lymphoma in the 1990s |
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