BACKGROUND AND METHODS: The aim of the study was to evaluate retrospectively clinical course of 27 patients with primary central nervous system lymphoma (PCNSL) diagnosed and treated by different surgical approaches. Initial therapy-diagnostic approach included surgery with total tumour reduction (TTR) performed in 12 patients (44.4%), while partial reduction and biopsy were performed in 8 (29.7%) and 7 (25.9%) patients, respectively. All patients were treated with chemotherapy based on high-dose methotrexate (HD-MTX) with/without whole-brain radiotherapy (WBRT). RESULTS: The median overall survival (OS) and event-free survival were 37 and 31 months, respectively, with overall response rate of 74%. The patients who underwent an open surgery with TTR had significantly longer OS (median not reached), comparing with partial tumour reduction or biopsy only (Log-Rank χ(2) 6.08, p = 0.014) when median OS was 23 months. In patients with performance status according to Eastern Cooperative Oncology Group (ECOG PS) ≥ 3, OS was 23 months, contrary to ECOG PS 1-2 when median was not reached. The International Extranodal Lymphoma Study Group score (low, intermediate and high) also influenced OS between three risk groups (Log-Rank χ(2) 12.5, p = 0.002). CONCLUSION: The treatment of PCNSL still remains doubtful, however possible benefit from the TTR followed with HD-MTX with/without WBRT should be reconsidered.
BACKGROUND AND METHODS: The aim of the study was to evaluate retrospectively clinical course of 27 patients with primary central nervous system lymphoma (PCNSL) diagnosed and treated by different surgical approaches. Initial therapy-diagnostic approach included surgery with total tumour reduction (TTR) performed in 12 patients (44.4%), while partial reduction and biopsy were performed in 8 (29.7%) and 7 (25.9%) patients, respectively. All patients were treated with chemotherapy based on high-dose methotrexate (HD-MTX) with/without whole-brain radiotherapy (WBRT). RESULTS: The median overall survival (OS) and event-free survival were 37 and 31 months, respectively, with overall response rate of 74%. The patients who underwent an open surgery with TTR had significantly longer OS (median not reached), comparing with partial tumour reduction or biopsy only (Log-Rank χ(2) 6.08, p = 0.014) when median OS was 23 months. In patients with performance status according to Eastern Cooperative Oncology Group (ECOG PS) ≥ 3, OS was 23 months, contrary to ECOG PS 1-2 when median was not reached. The International Extranodal Lymphoma Study Group score (low, intermediate and high) also influenced OS between three risk groups (Log-Rank χ(2) 12.5, p = 0.002). CONCLUSION: The treatment of PCNSL still remains doubtful, however possible benefit from the TTR followed with HD-MTX with/without WBRT should be reconsidered.
Authors: Hyeon Kang Koh; Il Han Kim; Tae Min Kim; Do Hoon Lim; Dongryul Oh; Jae Ho Cho; Woo-Chul Kim; Jin Hee Kim; Woong-Ki Chung; Bae-Kwon Jeong; Ki Mun Kang; Semie Hong; Chang-Ok Suh; In Ah Kim Journal: J Neurooncol Date: 2017-09-22 Impact factor: 4.130
Authors: Ali I Rae; Amol Mehta; Michael Cloney; Connor J Kinslow; Tony J C Wang; Govind Bhagat; Peter D Canoll; George J Zanazzi; Michael B Sisti; Sameer A Sheth; E Sander Connolly; Guy M McKhann; Jeffrey N Bruce; Fabio M Iwamoto; Adam M Sonabend Journal: Neurosurgery Date: 2019-04-01 Impact factor: 4.654
Authors: Jonathan Yun; Jingyan Yang; Michael Cloney; Amol Mehta; Suprit Singh; Fabio Massaiti Iwamoto; Alfred I Neugut; Adam M Sonabend Journal: Front Neurol Date: 2017-09-12 Impact factor: 4.003
Authors: Pierre Ferrer; Pablo Barbero; Gonzalo Monedero; Anna Lo Presti; Bartolome Bejarano; Juan Ramon Penanes Journal: Surg Neurol Int Date: 2020-05-23