Korean J Med.
2006 Dec;71(6):654-661.
Treatment outcomes of primary central nervous system lymphoma: Multi-center retrospective study
- Affiliations
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- 1Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea. sksohn@knu.ac.kr
- 2Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea.
- 3Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
- 4Department of Neurosurgery, Chonnam National University Medical School, Gwangju, Korea.
- 5Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
- 6Department of Internal Medicine, College of Medicine, Gyeongsang National University, Jinju, Korea.
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.
CONCLUSIONS
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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