Treatment strategies in primary vitreoretinal lymphoma: a 17-center European collaborative study.

Détails

Ressource 1Télécharger: BIB_88E8577BF4F3.P001.pdf (247.25 [Ko])
Etat: Public
Version: Final published version
ID Serval
serval:BIB_88E8577BF4F3
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Treatment strategies in primary vitreoretinal lymphoma: a 17-center European collaborative study.
Périodique
Jama Ophthalmology
Auteur⸱e⸱s
Riemens A., Bromberg J., Touitou V., Sobolewska B., Missotten T., Baarsma S., Hoyng C., Cordero-Coma M., Tomkins-Netzer O., Rozalski A., Tugal-Tutkun I., Guex-Crosier Y., Los L.I., Bollemeijer J.G., Nolan A., Pawade J., Willermain F., Bodaghi B., ten Dam-van Loon N., Dick A., Zierhut M., Lightman S., Mackensen F., Moulin A., Erckens R., Wensing B., le Hoang P., Lokhorst H., Rothova A.
ISSN
2168-6173 (Electronic)
ISSN-L
2168-6165
Statut éditorial
Publié
Date de publication
2015
Peer-reviewed
Oui
Volume
133
Numéro
2
Pages
191-197
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
IMPORTANCE: The best treatment option for primary vitreoretinal lymphoma (PVRL) without signs of central nervous system lymphoma (CNSL) involvement determined on magnetic resonance imaging or in cerebrospinal fluid is unknown.
OBJECTIVE: To evaluate the outcomes of treatment regimens used for PVRL in the prevention of subsequent CNSL.
DESIGN, SETTING, AND PARTICIPANTS: A retrospective cohort study was conducted at 17 referral ophthalmologic centers in Europe. We reviewed clinical, laboratory, and imaging data on 78 patients with PVRL who did not have CNSL on presentation between January 1, 1991, and December 31, 2012, with a focus on the incidence of CNS manifestations during the follow-up period.
INTERVENTIONS: The term extensive treatment was used for various combinations of systemic and intrathecal chemotherapy, whole-brain radiotherapy, and peripheral blood stem cell transplantation. Therapy to prevent CNSL included ocular radiotherapy and/or ocular chemotherapy (group A, 31 patients), extensive systemic treatment (group B, 21 patients), and a combination of ocular and extensive treatment (group C, 23 patients); 3 patients did not receive treatment. A total of 40 patients received systemic chemotherapy.
MAIN OUTCOMES AND MEASURES: Development of CNSL following the diagnosis of PVRL relative to the use or nonuse of systemic chemotherapy and other treatment regimens.
RESULTS: Overall, CNSL developed in 28 of 78 patients (36%) at a median follow-up of 49 months. Specifically, CNSL developed in 10 of 31 (32%) in group A, 9 of 21 (43%) in group B, and 9 of 23 (39%) in group C. The 5-year cumulative survival rate was lower in patients with CNSL (35% [95% CI, 50% to 86%]) than in patients without CNSL (68% [95% CI, 19% to 51%]; P = .003) and was similar among all treatment groups (P = .10). Adverse systemic effects occurred in 9 of 40 (23%) patients receiving systemic chemotherapy; the most common of these effects was acute renal failure.
CONCLUSIONS AND RELEVANCE: In the present series of patients with isolated PVRL, the use of systemic chemotherapy was not proven to prevent CNSL and was associated with more severe adverse effects compared with local treatment.
Pubmed
Web of science
Open Access
Oui
Création de la notice
28/01/2015 10:48
Dernière modification de la notice
20/08/2019 14:48
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