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Role of radiation therapy in primary central nervous system lymphoma

KROG 14–20 Collaborative Study of Brain and Lymphoma Committee

Journal of Neuro-Oncology volume 135, pages 629–638 (2017)Cite this article

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.

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Funding

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

Author information

Affiliations

  1. Department of Radiation Oncology, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 05030, Republic of Korea

    Hyeon Kang Koh & Semie Hong

  2. Department of Radiation Oncology, Seoul National University Hospital, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Il Han Kim

  3. Department of Internal Medicine, Seoul National University Hospital, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Tae Min Kim

  4. Department of Radiation Oncology, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea

    Do Hoon Lim & Dongryul Oh

  5. Department of Radiation Oncology, Yonsei Cancer Center, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul, 03722, Republic of Korea

    Jae Ho Cho & Chang-Ok Suh

  6. Department of Radiation Oncology, Inha University Hospital, 27 Inhang-ro, Chung-gu, Incheon, 22332, Republic of Korea

    Woo-Chul Kim

  7. Department of Radiation Oncology, Keimyung University Dongsan Medical Center, 56 Dalsung-ro, Chung-gu, Daegu, 41931, Republic of Korea

    Jin Hee Kim

  8. Department of Radiation Oncology, Chonnam National University Hospital, 322 Seoyang-ro, Hwasun-eub, Hwasun-gun, Chonnam, 58128, Republic of Korea

    Woong-Ki Chung

  9. Department of Radiation Oncology, Gyeongsang National University Hospital, 79 Gangnam-ro, Jinju-shi, Gyeongnam, 52727, Republic of Korea

    Bae-Kwon Jeong & Ki Mun Kang

  10. Department of Radiation Oncology, Seoul National University Bundang Hospital, 173 Gumi-ro, Seongnam-si, Kyeonggido, 13620, Republic of Korea

    In Ah Kim

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  1. Hyeon Kang Koh
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  2. Il Han Kim
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  3. Tae Min Kim
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  7. Woo-Chul Kim
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  8. Jin Hee Kim
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  10. Bae-Kwon Jeong
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  11. Ki Mun Kang
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  12. Semie Hong
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  13. Chang-Ok Suh
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  14. In Ah Kim
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Corresponding authors

Correspondence to Chang-Ok Suh or In Ah Kim.

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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.

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

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Koh, H.K., Kim, I.H., Kim, T.M. et al. Role of radiation therapy in primary central nervous system lymphoma. J Neurooncol 135, 629–638 (2017). https://doi.org/10.1007/s11060-017-2616-4

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Keywords

  • Radiotherapy
  • Central nervous system
  • Lymphoma
  • Methotrexate