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Milgrom, Sarah A; Pinnix, Chelsea C; Chi, T Linda; Vu, Thinh H; Gunther, Jillian R; Sheu, Tommy; Fowler, Nathan; Westin, Jason R; Nastoupil, Loretta J; Oki, Yasuhiro; Fayad, Luis E; Neelapu, Sattva; Rodriguez, Maria Alma; Hagemeister, Frederick B; Fanale, Michelle A; Lee, Hun J; Hosing, Chitra; Ahmed, Sairah; Nieto, Yago; Shpall, Elizabeth J; Dabaja, Bouthaina S
International journal of radiation oncology, biology, physics, 04/2018, Letnik: 100, Številka: 5Journal Article
We assessed the efficacy of radiation therapy (RT) in the management of secondary central nervous system (CNS) lymphoma. The cohort comprised 44 patients with systemic diffuse large B-cell lymphoma (DLBCL) secondarily involving the brain and/or leptomeninges at initial diagnosis or relapse that was treated with RT. Of these patients, 29 (66%) were in systemic remission when CNS disease was diagnosed. The overall response rate to RT by magnetic resonance imaging was 88% (42% complete, 46% partial). The median overall survival (OS) after RT initiation was 7 months (95% confidence interval 4-10 months). The OS curve plateaued at 31% from 2 to 8 years. OS was superior in patients who achieved a complete or partial response to RT, underwent stem cell transplantation after RT, and had brain parenchymal (vs leptomeningeal) disease. Eight cases of CNS disease progression occurred after RT: 1 involved the brain parenchyma, and 7 involved the spine and/or cerebrospinal fluid and/or meninges. We conclude that RT is associated with high response rates and may contribute to long-term OS. In addition, RT may provide CNS disease control that facilitates successful salvage with stem cell transplantation in patients with chemotherapy-refractory disease.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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in: SICRIS
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