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Journal of Neuro-Oncology

, Volume 135, Issue 3, pp 629–638 | Cite as

Role of radiation therapy in primary central nervous system lymphoma

KROG 14–20 Collaborative Study of Brain and Lymphoma Committee
  • 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 SuhEmail author
  • In Ah KimEmail author
Clinical Study

Abstract

We analyzed patterns of care and outcomes for patients with primary central nervous system lymphoma (PCNSL) in this multi-institutional retrospective study. Between January 2000 and December 2011, 220 patients with PCNSL received radiotherapy (RT). Among these patients, 26 patients received RT alone; 179 patients were treated with chemotherapy and radiotherapy; the rest of the patients (N = 15) initially underwent chemotherapy alone, then received RT as a salvage treatment. Most of the patients (N = 188) received methotrexate-based chemotherapy. The median follow up duration was 38 months (range 3–179 months). The median RT dose and whole brain RT (WBRT) dose were 45.0 Gy (range 20.0–59.4) and 30.6 Gy (range 18.0–45.0), respectively. Seventy-seven (35%) patients received WBRT alone, and 143 patients (65%) underwent WBRT plus boost RT. Total RT dose and WBRT dose decreased during the study period. The median survival was 64 months and actuarial 5-year overall survival was 51.4%. In multivariate analysis, age (P < 0.001), ECOG performance status (P = 0.036), deep structure involvement (P = 0.011) and treatment response (P = 0.001) were significant prognosticators. RT combined with chemotherapy is effective modality for treatment of PCNSL. The survival outcome improved in spite of total radiation dose and whole brain RT (WBRT) dose having been decreased over the study period, indicating that low-dose WBRT could be effective.

Keywords

Radiotherapy Central nervous system Lymphoma Methotrexate 

Notes

Funding

Work supported by Grants #0820010 from the Korean Ministry of Health and Welfare and to In Ah Kim.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by each participating institution’s review board (IRB) and the protocol review committee of KROG.

Informed consent

The retrospective design exempted this study from the requirement to obtain written informed consent from the patients.

Supplementary material

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Supplementary material 1 (TIF 31 KB)
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Supplementary material 3 (TIF 96 KB)
11060_2017_2616_MOESM4_ESM.doc (37 kb)
Supplementary material 4 (DOC 37 KB)

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of Radiation OncologyKonkuk University Medical CenterSeoulRepublic of Korea
  2. 2.Department of Radiation OncologySeoul National University HospitalSeoulRepublic of Korea
  3. 3.Department of Internal MedicineSeoul National University HospitalSeoulRepublic of Korea
  4. 4.Department of Radiation OncologySamsung Medical CenterSeoulRepublic of Korea
  5. 5.Department of Radiation OncologyYonsei Cancer CenterSeoulRepublic of Korea
  6. 6.Department of Radiation OncologyInha University HospitalIncheonRepublic of Korea
  7. 7.Department of Radiation OncologyKeimyung University Dongsan Medical CenterDaeguRepublic of Korea
  8. 8.Department of Radiation OncologyChonnam National University HospitalChonnamRepublic of Korea
  9. 9.Department of Radiation OncologyGyeongsang National University HospitalGyeongnamRepublic of Korea
  10. 10.Department of Radiation OncologySeoul National University Bundang HospitalKyeonggidoRepublic of Korea

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