The authors report on 17 patients having primary central nervous system (CNS) lymphomas between January, 1981 and August, 1992. All patients were treated at Seoul National University Hospital. Only three cases underwent surgery only and fourteen
cases
underwent surgery and radiation therapy with or without chemotherapy. There were no immunosuppressive patients.
Sixteen patients were analyzed for survival studies, because one case was lost during follow-up. The median survival time (MST) was 26 months and one- and two-year survival rates for the 16 patients were 87.5% and 65.6% respectively. The rate of
survival was analyzed according. to possible prognostic factors ; age and sex. Multiplicity and location of tumors, preoperative Karnofsky performance score (KPS), pathological subclassification, type of surgery, preoperative steroid therapy,
postoperative adjuvant therapy, extent of radiation, chemotherapy and the degree of response to treatment at three months follow-up. Postoperative adjuvant therapy and the degree of response to the treatment correlated with survival.
Fourteen patients who underwent postoperative adjuvant therapy had a median survival time of 63 months. The one- and two-year survival rates were 100% and 75% respectively compared to the MST of 1.5 months with survival rates of 0% and 0%
retrospectively for the two patients who did not. A higher long term survival rate was observed in the group with better immediate responses. In nine of 16 patients with complete responses, the MST, one-, and two-year survival rates were 63
months,
100%, and 83% respectively.
The authors suggest that preoperative application of steroids may be considered in case of clinically suspected primary CNS lymphomas. It is concluded that after obtaining the tissue diagnosis of primary CNS lymphomas, radiotherapy with or
without
chemotherapy should be performed until the complete response.
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