Gaëlle Fossard1, Céline Ferlay2, Emmanuelle Nicolas-Virelizier1, Philippe Rey1, François Ducray3, Emmanuel Jouanneau4, Pierre Faurie1, Amine Belhabri1, Marie-Pierre Sunyack5, Catherine Chassagne-Clément6, Philippe Thiesse7, Catherine Sebban1, Pierre Biron1, Jean-Yves Blay1, Hervé Ghesquières8. 1. Centre Léon Bérard, Department of Hematology, Université Claude Bernard Lyon 1, Lyon, France. 2. Centre Léon Bérard, Department of Statistics, Université Claude Bernard Lyon 1, Lyon, France. 3. Hopital Neurologique, Department of Neurology, Université Claude Bernard Lyon 1, Bron, France. 4. Hopital Neurologique, Department of Neurosurgery, Université Claude Bernard Lyon 1, Bron, France. 5. Centre Léon Bérard, Department of Radiotherapy, Université Claude Bernard Lyon 1, Lyon, France. 6. Centre Léon Bérard, Department of Pathology, Université Claude Bernard Lyon 1, Lyon, France. 7. Centre Léon Bérard, Department of Radiology, Université Claude Bernard Lyon 1, Lyon, France. 8. Centre Léon Bérard, Department of Hematology, Université Claude Bernard Lyon 1, Lyon, France; Department of Hematology, Centre Hospitalier Lyon Sud, Université Claude Bernard Lyon 1, Pierre-Bénite, France. Electronic address: herve.ghesquieres@chu-lyon.fr.
Abstract
BACKGROUND: The optimal follow-up strategy for primary central nervous system lymphoma (PCNSL) patients after first-line therapy is unclear. The goal of this study is to determine the utility of planned brain surveillance imaging in the detection of relapse in a retrospective cohort of PCNSL patients. METHODS: Patients were consecutive PCNSL cases treated in Leon Berard Cancer Centre, Lyon, France, from 1985 to 2011. Histology was diffuse large B-cell lymphoma in 94%. Patients were treated by methotrexate (92%) and cytarabine (63%) based-chemotherapy followed by radiotherapy for 108 patients (51%). Clinical records were reviewed for details at relapse and relationship to planned imaging. The imaging follow-up strategy was performed according to each treating physicians. RESULTS: Among 209 PCNSL patients, 127 complete response patients entered in post-treatment observation and 63 (50%) subsequently relapsed. Among the 125 evaluable patients, the majority of relapses (N = 49, 80%) was asymptomatic and identified before the planned brain imaging. Surveillance imaging detected relapses before symptoms in 12 patients who entered in post-therapy observation (10%). The median number of brain imaging during the follow-up was 7 (0-13). A total of 819 MRI/CT-scan were performed leading to the detection of 12 asymptomatic relapses. The one year OS rates were 41% and 58% for symptomatic and non-symptomatic relapses, respectively (P = 0.21). CONCLUSION: The majority of PCNSL relapses occurred outside planned follow-up with no difference in patient outcome between symptomatic and asymptomatic relapses. The role of brain imaging for the detection of relapses in the follow-up of PCNSL patients remains to be clarified.
BACKGROUND: The optimal follow-up strategy for primary central nervous system lymphoma (PCNSL) patients after first-line therapy is unclear. The goal of this study is to determine the utility of planned brain surveillance imaging in the detection of relapse in a retrospective cohort of PCNSLpatients. METHODS:Patients were consecutive PCNSL cases treated in Leon Berard Cancer Centre, Lyon, France, from 1985 to 2011. Histology was diffuse large B-cell lymphoma in 94%. Patients were treated by methotrexate (92%) and cytarabine (63%) based-chemotherapy followed by radiotherapy for 108 patients (51%). Clinical records were reviewed for details at relapse and relationship to planned imaging. The imaging follow-up strategy was performed according to each treating physicians. RESULTS: Among 209 PCNSLpatients, 127 complete response patients entered in post-treatment observation and 63 (50%) subsequently relapsed. Among the 125 evaluable patients, the majority of relapses (N = 49, 80%) was asymptomatic and identified before the planned brain imaging. Surveillance imaging detected relapses before symptoms in 12 patients who entered in post-therapy observation (10%). The median number of brain imaging during the follow-up was 7 (0-13). A total of 819 MRI/CT-scan were performed leading to the detection of 12 asymptomatic relapses. The one year OS rates were 41% and 58% for symptomatic and non-symptomatic relapses, respectively (P = 0.21). CONCLUSION: The majority of PCNSL relapses occurred outside planned follow-up with no difference in patient outcome between symptomatic and asymptomatic relapses. The role of brain imaging for the detection of relapses in the follow-up of PCNSLpatients remains to be clarified.
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: Elizabeth A Mullen; Yueh-Yun Chi; Emily Hibbitts; James R Anderson; Katarina J Steacy; James I Geller; Daniel M Green; Geetika Khanna; Marcio H Malogolowkin; Paul E Grundy; Conrad V Fernandez; Jeffrey S Dome Journal: J Clin Oncol Date: 2018-10-18 Impact factor: 44.544
Authors: Matthias Mulazzani; Simon P Fräßle; Iven von Mücke-Heim; Sigrid Langer; Xiaolan Zhou; Hellen Ishikawa-Ankerhold; Justin Leube; Wenlong Zhang; Sarah Dötsch; Mortimer Svec; Martina Rudelius; Martin Dreyling; Michael von Bergwelt-Baildon; Andreas Straube; Veit R Buchholz; Dirk H Busch; Louisa von Baumgarten Journal: Proc Natl Acad Sci U S A Date: 2019-11-11 Impact factor: 11.205