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KMID : 0882420060710060654
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Korean Journal of Medicine
2006 Volume.71 No. 6 p.654 ~ p.661
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Treatment outcomes of primary central nervous system lymphoma: Multi-center retrospective study.
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Moon Joon-Ho
Kim Dong-Hwan
Ahn Byung-Min
Kim Shi-Nae
Jeon Seok-Bong
Baek Jin-Ho
Kim Jong-Gwang
Sohn Sang-Kyun
Lee Kyu-Bo
Hwang Jeong-Hyun
Hwang Sung-Kyoo
Lee Je-Jung
Kim Yeo-Kyeoung
Chung Ik-Joo
Kim Hyeoung-Joon
Yang Deok-Hwan
Jung Shin
Do Young-Rok
Kwon Ki-Young
Song Hong-Suk
Lee Won-Seop
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Abstract
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Background: A primary central nervous system lymphoma (PCNSL) is a rare neoplasm with a poor prognosis. The treatment of PCNSL involves a combination of chemotherapy, intrathecal chemotherapy and radiotherapy. This study retrospectively evaluated the treatment outcomes and prognostic factors of Korean patients with PCNSL.
Methods: Between 1995 and 2003, 58 patients diagnosed with PCNSL from the multi-center hospitals were enrolled in this study. Among 56 patients who had received treatment, 16 patients were treated with radiotherapy alone, while 40 patients were treated with combined chemotherapy (CHOP; 9 cases, high-dose methotrexate; 31 cases) and radiotherapy.
Results: The median age of the patients was 58 years (range, 19-76). A diffuse large B-cell lymphoma was diagnosed in 56 cases (96.6%), while a peripheral T-cell lymphoma was diagnosed in 2 cases. Of the 47 patients who could be assessed for their response after treatment, a CR and PR was observed in 32 (68%) and 11 patients (23%), respectively, giving an overall response rate of 91% (95% CI, 82~100%). The estimated 3-year overall survival rate for all the patients was 67+/-7.9% and the 3-year disease free survival rate was 53+/-8.3%. The overall survival of the high-dose methotrexate group was superior to that of the CHOP group (77+/-10% versus 47+/-19%, p=0.05). Leukoencephalopathy was observed as a late complication in 9 patients (21%). No significant prognostic factors affecting survival were found by univariate analysis.
Conclusion: Approximately half of the patients could have long-term survival after treatment in this study. High-dose methotrexate containing chemotherapy followed by radiotherapy was found to be an effective treatment.
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KEYWORD
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Lymphoma, Central Nervous System, CHOP, High-dose methotrexate, Radiotherapy
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