Magdalena Neuhauser1,2, Thomas Roetzer1,2, Stefan Oberndorfer3, Melitta Kitzwoegerer4, Franz Payer5, Julia J Unterluggauer6, Johannes Haybaeck6,7, Günther Stockhammer8, Sarah Iglseder8, Patrizia Moser9, Claudius Thomé10, Martin Stultschnig11, Franz Wuertz12, Tanisa Brandner-Kokalj12, Serge Weis13, Dave Bandke13, Josef Pichler14, Markus Hutterer15, Karl J Krenosz16, Alexandra Boehm17, Beate Mayrbaeurl18, Andrea Hager-Seifert19, Hannes Kaufmann20, Martina Dumser21, Angelika Reiner-Concin22, Selma Hoenigschnabl22, Waltraud Kleindienst23, Markus Hoffermann24, Karin Dieckmann2,25, Barbara Kiesel2,26, Georg Widhalm2,26, Christine Marosi2,27, Ulrich Jaeger2,27, Andreas Hainfellner1,2, Monika Hackl28, Johannes A Hainfellner1,2, Matthias Preusser2,27, Adelheid Woehrer1,2. 1. a Institute of Neurology , Medical University of Vienna , Vienna , Austria. 2. b Comprehensive Cancer Center , Medical University of Vienna , Vienna , Austria. 3. c Department of Neurology , University Hospital St. Poelten, Karl Landsteiner University of Health Sciences , St. Poelten , Austria. 4. d Department of Pathology , University Hospital St. Poelten Karl Landsteiner University of Health Sciences , St. Poelten , Austria. 5. e Department of Neurology , Medical University of Graz , Graz , Austria. 6. f Department of Neuropathology , Institute of Pathology, Medical University of Graz , Graz , Austria. 7. g Department of Pathology , Otto-von-Guericke University of Magdeburg , Magdeburg , Germany. 8. h Department of Neurology , Medical University of Innsbruck , Innsbruck , Austria. 9. i Department of Pathology , Medical University of Innsbruck , Innsbruck , Austria. 10. j Department of Neurosurgery , Medical University of Innsbruck , Innsbruck , Austria. 11. k Department of Neurology , State Hospital Klagenfurt , Klagenfurt , Austria. 12. l Institute of Pathology, State Hospital Klagenfurt , Klagenfurt , Austria. 13. m Department of Neuropathology , Neuromed Campus, Kepler University Hospital, Johannes Kepler University of Linz , Linz , Austria. 14. n Department of Internal Medicine and Neurooncology, Neuromed Campus, Kepler University Hospital, Johannes Kepler University of Linz, Linz, Austria. 15. o Department of Neurology , Neuromed Campus, Kepler University Hospital, Johannes Kepler University of Linz , Linz , Austria. 16. p Department of Hematology and Oncology , Kepler University Hospital, Johannes Kepler University of Linz , Linz , Austria. 17. q Department of Internal Medicine, Hematology and Oncology , Hospital Elisabethinen , Linz , Austria. 18. r Department of Internal Medicine IV , Hospital Wels-Grieskirchen , Wels-Grieskirchen , Austria. 19. s Department of Neurology , State Hospital Wiener Neustadt , Wiener Neustadt , Austria. 20. t Department of Oncology , Krankenanstalt Rudolfstiftung , Vienna , Austria. 21. u Department of Pathology , Krankenanstalt Rudolfstiftung , Vienna , Austria. 22. v Department of Pathology , Donauspital Vienna , Vienna , Austria. 23. w Department of Neurology , Paracelsus Medical University Salzburg , Salzburg , Austria. 24. x Department of Neurosurgery , State Hospital Feldkirch , Feldkirch , Austria. 25. y Department of Radiotherapy , Medical University of Vienna , Vienna , Austria. 26. z Department of Neurosurgery , Medical University of Vienna , Vienna , Austria. 27. aa Department of Medicine I , Medical University of Vienna , Vienna , Austria. 28. ab Austrian National Cancer Registry , Statistics Austria , Vienna , Austria.
Abstract
Background: Primary CNS lymphoma is a highly aggressive and rare type of extranodal non-Hodgkin lymphoma. Although, new therapeutic approaches have led to improved survival, the management of the disease poses a challenge, practice patterns vary across institutions and countries, and remain ill-defined for vulnerable patient subgroups. Material and Methods: Using information from the Austrian Brain Tumor Registry we followed a population-based cohort of 189 patients newly diagnosed from 2005 to 2010 through various lines of treatment until death or last follow-up (12-31-2016). Prognostic factors and treatment-related data were integrated in a comprehensive survival analysis including conditional survival estimates. Results: We find variable patterns of first-line treatment with increasing use of rituximab and high-dose methotrexate (HDMTX)-based poly-chemotherapy after 2007, paralleled by an increase in median overall survival restricted to patients aged below 70 years. In the entire cohort, 5-year overall survival was 24.4% while 5-year conditional survival increased with every year postdiagnosis. Conclusion: In conclusion, we show that the use of poly-chemotherapy and immunotherapy has disseminated to community practice to a fair extent and survival has increased over time at least in younger patients. Annually increasing conditional survival rates provide clinicians with an adequate and encouraging prognostic measure.
Background: Primary CNS lymphoma is a highly aggressive and rare type of extranodal non-Hodgkin lymphoma. Although, new therapeutic approaches have led to improved survival, the management of the disease poses a challenge, practice patterns vary across institutions and countries, and remain ill-defined for vulnerable patient subgroups. Material and Methods: Using information from the Austrian Brain Tumor Registry we followed a population-based cohort of 189 patients newly diagnosed from 2005 to 2010 through various lines of treatment until death or last follow-up (12-31-2016). Prognostic factors and treatment-related data were integrated in a comprehensive survival analysis including conditional survival estimates. Results: We find variable patterns of first-line treatment with increasing use of rituximab and high-dose methotrexate (HDMTX)-based poly-chemotherapy after 2007, paralleled by an increase in median overall survival restricted to patients aged below 70 years. In the entire cohort, 5-year overall survival was 24.4% while 5-year conditional survival increased with every year postdiagnosis. Conclusion: In conclusion, we show that the use of poly-chemotherapy and immunotherapy has disseminated to community practice to a fair extent and survival has increased over time at least in younger patients. Annually increasing conditional survival rates provide clinicians with an adequate and encouraging prognostic measure.
Authors: Florian Scheichel; Daniel Pinggera; Branko Popadic; Camillo Sherif; Franz Marhold; Christian Franz Freyschlag Journal: Front Oncol Date: 2022-04-20 Impact factor: 5.738
Authors: Matthijs van der Meulen; Jacoline E C Bromberg; Marcel Nijland; Otto Visser; Jeanette K Doorduijn; Avinash G Dinmohamed Journal: Haematologica Date: 2021-02-01 Impact factor: 9.941