Document Detail


Primary central nervous system lymphoma in the elderly: a multicentre retrospective analysis.
MedLine Citation:
PMID:  20738305     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Elderly patients with primary central nervous ystem lymphoma (PCNSL) do not tolerate treatment with combined radio-chemotherapy well because of leuco-encephalopathy; they are usually treated initially with chemotherapy or radiotherapy alone. Little is known about the efficacy and toxicity of these treatments outside clinical studies. This study was a retrospective analysis of all patients aged 60 years or over who were admitted with PCNSL to one of five Dutch centers between 1998 and 2007. A total of 74 patients were identified. Twenty-nine were treated with radiotherapy only (Group A), in 36 the intended treatment was chemotherapy alone (Group B), and nine were planned to receive chemotherapy followed by radiotherapy (Group C). Median overall survival was 20 months; 4 months in patients with a Karnofsky performance status (KPS) <70, 25 months in patients with a KPS ≥ 70 (P < 0·001). Treatment modality was not an independent prognostic factor. Forty patients were treated with methotrexate 3 g/m(2) : there were two toxic deaths. Ten patients discontinued chemotherapy because of toxicity. Delayed encephalopathy was reported in 10 patients. In conclusion, community hospitals still frequently utilize whole brain radiotherapy in elderly PCNSL patients, though a majority tolerates chemotherapy well. Performance status was the most important variable determining prognosis. Short and long term toxicities must be weighed against possible clinical benefits of each treatment, making treatment decisions a highly individualized process.
Authors:
Mascha Schuurmans; Jacoline E C Bromberg; Jeanette Doorduijn; Philip Poortmans; Martin J B Taphoorn; Tatjana Seute; Roelien Enting; Gustaaf van Imhoff; Yvette van Norden; Martin J van den Bent
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2010-08-25
Journal Detail:
Title:  British journal of haematology     Volume:  151     ISSN:  1365-2141     ISO Abbreviation:  Br. J. Haematol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-29     Completed Date:  2010-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372544     Medline TA:  Br J Haematol     Country:  England    
Other Details:
Languages:  eng     Pagination:  179-84     Citation Subset:  IM    
Copyright Information:
© 2010 Blackwell Publishing Ltd.
Affiliation:
Department of Neuro-Oncology, Daniël den Hoed Cancer Centre, Erasmus MC, Rotterdam, the Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Antineoplastic Agents / administration & dosage,  adverse effects
Central Nervous System Neoplasms / drug therapy*,  radiotherapy*
Combined Modality Therapy
Epidemiologic Methods
Humans
Lymphoma, Non-Hodgkin / drug therapy*,  radiotherapy*
Methotrexate / administration & dosage,  adverse effects
Middle Aged
Prognosis
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 59-05-2/Methotrexate

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