Clinical presentation and therapeutic outcome in 26 patients with primary CNS lymphoma

Acta Neurol Scand. 1998 Apr;97(4):257-64. doi: 10.1111/j.1600-0404.1998.tb00647.x.

Abstract

This retrospective study analyzes clinical features and therapeutic outcome in 26 immunocompetent patients with primary central nervous system lymphoma (PCNSL). Most patients presented with personality changes. PCNSL lesions were mainly iso- or hyperdense, enhancing lesions on CT scan, hypointensive on T1-, and hyperintensive on T2-weighted MRI. Multiple lesions were found in about 60% of patients. Nine of 11 patients receiving radiotherapy alone showed complete remission (CR). Median survival time after diagnosis (MST) was 13 months. Seven patients received intravenous and intrathecal methotrexate, radiotherapy, and postirradiation intravenous cytarabine. Six of these patients had CR and 5 patients are alive in CR after a median follow-up of 12 months. Five patients received various other radiochemotherapy regimens (MST 6 months), and 3 patients died before receiving any radio- or chemotherapy. Our preliminary treatment results show a tendency to improved survival with radiochemotherapy. This is consistent with pertinent data from the literature which favors radiochemotherapy for patients with PCNSL.

Publication types

  • Comparative Study

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biopsy
  • Bone Marrow / pathology
  • Brain Neoplasms / diagnosis*
  • Brain Neoplasms / mortality
  • Brain Neoplasms / therapy*
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • Cytarabine / administration & dosage
  • Dexamethasone / administration & dosage
  • Doxorubicin / administration & dosage
  • Follow-Up Studies
  • Humans
  • Lymphoma / diagnosis*
  • Lymphoma / mortality
  • Lymphoma / therapy*
  • Methotrexate / administration & dosage
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnosis
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Recurrence, Local / radiotherapy
  • Prednisone / administration & dosage
  • Premedication
  • Radiotherapy Dosage
  • Retrospective Studies
  • Survival Analysis
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vincristine / administration & dosage

Substances

  • Adrenal Cortex Hormones
  • Cytarabine
  • Vincristine
  • Dexamethasone
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone
  • Methotrexate

Supplementary concepts

  • CHOP protocol