Salvage whole brain radiotherapy for recurrent or refractory primary CNS lymphoma.

Détails

ID Serval
serval:BIB_194C77260E16
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Salvage whole brain radiotherapy for recurrent or refractory primary CNS lymphoma.
Périodique
Neurology
Auteur(s)
Hottinger A.F., DeAngelis L.M., Yahalom J., Abrey L.E.
ISSN
1526-632X (Electronic)
ISSN-L
0028-3878
Statut éditorial
Publié
Date de publication
2007
Peer-reviewed
Oui
Volume
69
Numéro
11
Pages
1178-1182
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
BACKGROUND: High-dose methotrexate (MTX) and whole brain radiation therapy (WBRT) prolong survival in primary CNS lymphoma (PCNSL) patients but have been associated with delayed neurotoxicity. Consequently, patients are often treated with chemotherapy alone, and WBRT is deferred until relapse.
METHODS: We performed a retrospective study to evaluate the safety and efficacy of salvage WBRT. Radiographic response, survival, and late neurotoxicity were assessed as the main endpoints.
RESULTS: Forty-eight patients received salvage WBRT for PCNSL progression or recurrence. After WBRT, 58% achieved a complete radiographic response, 21% achieved a partial response, 6% had stable disease, and 15% progressed. The median survival from initiation of WBRT was 16 months, and 54% were alive 1 year after WBRT. The median time to PCNSL progression was 10 months; 15 patients (31%) had no subsequent disease recurrence after WBRT. Age younger than 60 years and complete response to WBRT were associated with better outcome. Treatment-related neurotoxicity was observed in 22% of patients. Patients older than 60 years and those treated less than 6 months from MTX therapy were at increased risk for development of neurotoxicity.
CONCLUSIONS: Salvage whole brain radiation therapy (WBRT) is effective for recurrent and refractory primary CNS lymphoma. Reserving WBRT until tumor recurrence is a reasonable strategy to minimize or delay the risk of treatment-related neurotoxicity.
Mots-clé
Age Factors, Aged, Antineoplastic Agents/administration & dosage, Brain/physiopathology, Brain/radiation effects, Brain Neoplasms/drug therapy, Brain Neoplasms/radiotherapy, Female, Humans, Lymphoma/drug therapy, Lymphoma/radiotherapy, Male, Middle Aged, Neoplasm Recurrence, Local/radiotherapy, Nerve Degeneration/etiology, Nerve Degeneration/prevention & control, Radiation Dosage, Radiotherapy/adverse effects, Radiotherapy/statistics & numerical data, Retrospective Studies, Risk Assessment, Risk Factors, Survival Rate, Treatment Outcome
Pubmed
Création de la notice
19/02/2014 22:34
Dernière modification de la notice
20/08/2019 13:50
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