Survival improvement with combined radio-chemotherapy in the primary central nervous system lymphomas

J Korean Med Sci. 1999 Oct;14(5):565-70. doi: 10.3346/jkms.1999.14.5.565.

Abstract

The benefits of radio-chemotherapy in HIV-negative primary central nervous system (CNS) lymphomas were analyzed in 40 patients, who received radiotherapy to the brain or craniospinal axis with the total dose of 4460-5940 cGy to the primary tumor. Radiotherapy was followed by systemic chemotherapy, mainly with the cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP) regimen, in 16 of the patients. Follow-up ranged from four to 95 months with a median of 15 months. The relapse rate was 72.5%, and 83% of the relapses occurred within the radiation field. Median survival was 19 months and the two-year survival rate was 41%. Survival was significantly influenced by treatment method and radiation dose when measured by univariate analysis; median survival and the two-year survival rate was 29 months and 63% after radio-chemotherapy, while 13.5 month and 29% after radiotherapy alone (p= 0.027), and 22 months and 49% with doses of 50 Gy or more, but 12.5 months and 13% with doses less than 50 Gy (p=0.009). However, statistical significance was lost in multivariate analysis. These results might suggest the short-term efficacy of radio-chemotherapy, however, cautious observation is needed to confirm long-term effects.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bleomycin / administration & dosage
  • Central Nervous System Neoplasms / mortality
  • Central Nervous System Neoplasms / therapy*
  • Cyclophosphamide / administration & dosage
  • Disease-Free Survival
  • Doxorubicin / administration & dosage
  • Epirubicin / administration & dosage
  • Female
  • Humans
  • Lymphoma / mortality
  • Lymphoma / therapy*
  • Male
  • Mechlorethamine / administration & dosage
  • Methotrexate / administration & dosage
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Prednisolone / administration & dosage
  • Procarbazine / administration & dosage
  • Radiotherapy Dosage
  • Radiotherapy, Adjuvant / adverse effects
  • Survival Rate
  • Treatment Failure
  • Vincristine / administration & dosage

Substances

  • Bleomycin
  • Procarbazine
  • Epirubicin
  • Mechlorethamine
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisolone
  • Methotrexate

Supplementary concepts

  • CEVBP protocol
  • MOP protocol
  • VAP-cyclo protocol