Outcome and patterns of failure in testicular lymphoma: a multicenter Rare Cancer Network study.
Détails
ID Serval
serval:BIB_804FA61D8FBF
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Outcome and patterns of failure in testicular lymphoma: a multicenter Rare Cancer Network study.
Périodique
International journal of radiation oncology, biology, physics
ISSN
0360-3016
Statut éditorial
Publié
Date de publication
2002
Peer-reviewed
Oui
Volume
52
Numéro
3
Pages
652-6
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study - Publication Status: ppublish
Résumé
PURPOSE: To assess the outcome and patterns of failure in patients with testicular lymphoma treated by chemotherapy (CT) and/or radiation therapy (RT). METHODS AND MATERIALS: Data from a series of 36 adult patients with Ann Arbor Stage I (n = 21), II (n = 9), III (n = 3), or IV (n = 3) primary testicular lymphoma, consecutively treated between 1980 and 1999, were collected in a retrospective multicenter study by the Rare Cancer Network. Median age was 64 years (range: 21-91 years). Full staging workup (chest X-ray, testicular ultrasound, abdominal ultrasound, and/or thoracoabdominal computer tomography, bone marrow assessment, full blood count, lactate dehydrogenase, and cerebrospinal fluid evaluation) was completed in 18 (50%) patients. All but one patient underwent orchidectomy, and spermatic cord infiltration was found in 9 patients. Most patients (n = 29) had CT, consisting in most cases of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) with (n = 17) or without intrathecal CT. External RT was delivered to scrotum alone (n = 12) or testicular, iliac, and para-aortic regions (n = 8). The median RT dose was 31 Gy (range: 20-44 Gy) in a median of 17 fractions (10-24), using a median of 1.8 Gy (range: 1.5-2.5 Gy) per fraction. The median follow-up period was 42 months (range: 6-138 months). RESULTS: After a median period of 11 months (range: 1-76 months), 14 patients presented lymphoma progression, mostly in the central nervous system (CNS) (n = 8). Among the 17 patients who received intrathecal CT, 4 had a CNS relapse (p = NS). No testicular, iliac, or para-aortic relapse was observed in patients receiving RT to these regions. The 5-year overall, lymphoma-specific, and disease-free survival was 47%, 66%, and 43%, respectively. In univariate analyses, statistically significant factors favorably influencing the outcome were early-stage and combined modality treatment. Neither RT technique nor total dose influenced the outcome. Multivariate analysis revealed that the most favorable independent factors predicting the outcome were younger age, early-stage disease, and combined modality treatment. CONCLUSIONS: In this multicenter retrospective study, CNS was found to be the principal site of relapse, and no extra-CNS lymphoma progression was observed in the irradiated volumes. More effective CNS prophylaxis, including combined modalities, should be prospectively explored in this uncommon site of extranodal lymphoma.
Mots-clé
Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Combined Modality Therapy, Cyclophosphamide, Disease-Free Survival, Doxorubicin, Humans, Lymphoma, Non-Hodgkin, Male, Middle Aged, Neoplasm Staging, Orchiectomy, Prednisolone, Prognosis, Radiotherapy Dosage, Recurrence, Retrospective Studies, Testicular Neoplasms, Treatment Failure, Treatment Outcome, Vincristine
Pubmed
Web of science
Création de la notice
24/01/2008 18:20
Dernière modification de la notice
20/08/2019 15:40