Primary Central Nervous System Lymphomas of the Brain: A Retrospective Analysis in a Single Institution

Autor: Tu Hsueh Yeh, Kuo Chen Wei, Pin Yuan Chen, Shih-Ming Jung, Chih Cheng Chuang, Po Hsun Tu, Tzu-Kang Lin, Peng Wei Hsu, Yin Cheng Huang
Rok vydání: 2016
Předmět:
Male
Lymphoma
medicine.medical_treatment
Biopsy
Kaplan-Meier Estimate
Neurosurgical Procedures
0302 clinical medicine
Antineoplastic Combined Chemotherapy Protocols
Medical diagnosis
Injections
Spinal
Aged
80 and over
medicine.diagnostic_test
Brain Neoplasms
Cytarabine
Cytoreduction Surgical Procedures
Middle Aged
Debulking
Prognosis
Burkitt Lymphoma
Magnetic Resonance Imaging
Survival Rate
medicine.anatomical_structure
030220 oncology & carcinogenesis
Administration
Intravenous
Female
Lymphoma
Large B-Cell
Diffuse
Craniotomy
medicine.drug
Adult
medicine.medical_specialty
Adolescent
Lymphoma
T-Cell
03 medical and health sciences
Young Adult
medicine
Humans
Aged
Retrospective Studies
Chemotherapy
L-Lactate Dehydrogenase
business.industry
Surgery
Radiation therapy
Clinical trial
Methotrexate
Neurology (clinical)
Bone marrow
Cranial Irradiation
business
030217 neurology & neurosurgery
Zdroj: World neurosurgery. 103
ISSN: 1878-8769
Popis: Background Primary central nervous system lymphomas (PCNSLs) are relatively rare brain tumors. Accurate diagnosis is usually made by surgical biopsy. In addition to surgical biopsy and decompression, treatment options include high-dose methotrexate and chemotherapy, radiation therapy, and stem cell therapy. Because of the rarity of this disease, guidelines for PCNSL diagnosis and treatment usually are formed from a large series of experiences. Methods We retrospectively reviewed 79 patients in our tertiary referral center during a 13-year period. All patients with PCNSL underwent surgical or bone marrow biopsy procedures, and diagnoses were confirmed by hematologists or neuropathologists. At the time of diagnosis, 44 patients presented with a single lesion. Human immunodeficiency virus was confirmed positive in 1 patient. The standard therapy protocol included high-dose methotrexate (intravenous and intrathecal) and chemotherapy with cytosine arabinoside, followed by external irradiation of the brain. Results Significant prognostic factors in these patients were low serum lactate dehydrogenase levels and radiation therapy. Multiplicity of lesions at time of diagnosis did not imply a worse outcome, and surgical resection and debulking did not show a significant survival benefit. Conclusions PCNSL has a poor prognosis. Further clinical trials and diagnostic tools are needed to reveal the complexity of this disease.
Databáze: OpenAIRE
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