Combined-modality therapy in the treatment of primary central nervous system lymphoma in AIDS Journal Article
| Authors: | Forsyth, P. A.; Yahalom, J.; DeAngelis, L. M. |
| Article Title: | Combined-modality therapy in the treatment of primary central nervous system lymphoma in AIDS |
| Abstract: | Purpose: Conventional therapy–ie, treatment with corticosteroids and cranial radiotherapy (RT)–is inadequate to treat AIDS-related primary central nervous system lymphoma (PCNSL), as it achieves a median survival of only 2 to 5 months. Chemotherapy added to RT in non-AIDS PCNSL improves disease control and prolongs survival. We studied the efficacy of this approach with RT in AIDS-related PCNSL. Methods: Ten AIDS patients with PCNSL were treated with chemotherapy–nine at diagnosis and one at recurrence. None had evidence of systemic lymphoma. All patients treated at diagnosis received pre-RT methotrexate–eight also received thiotepa and procarbazine–followed by whole-brain RT. The patient treated at recurrence (who had been previously irradiated) received chemotherapy alone, including methotrexate, thiotepa, and procarbazine. Results: All had enhancing lesions on MRI and five (50%) had a single lesion (seven [70%] had a ring-enhancing mass). No patient had a response to corticosteroids. Four of seven (57%) assessable patients had a partial or complete response to chemotherapy prior to RT. Six of seven (86%) assessable patients had a complete response at the end of treatment. Median survival was 3.5 months for all 10 patients and 7 months for the eight patients who completed therapy. Two patients survived for 1 year or longer. Eight patients died–six from infection (two treatment-related), one from progressive dementia, and one from a gastrointestinal hemorrhage. Conclusion: AIDS-related PCNSL responds to chemotherapy and RT, but only a few patients benefit with prolonged survival. © 1994 American Academy of Neurology. |
| Keywords: | adult; cancer survival; clinical article; controlled study; middle aged; clinical trial; cancer combination chemotherapy; antineoplastic agents; cancer radiotherapy; combined modality therapy; methotrexate; nuclear magnetic resonance imaging; magnetic resonance imaging; controlled clinical trial; neoplasm recurrence, local; procarbazine; thiotepa; skull irradiation; cranial irradiation; central nervous system neoplasms; brain; acquired immune deficiency syndrome; corticosteroid; lymphoma, aids-related; intravenous drug administration; zidovudine; brain lymphoma; sulfamethoxazole; trimethoprim; corticosteroid therapy; humans; human; male; female; priority journal; article; intrathecal drug administration |
| Journal Title: | Neurology |
| Volume: | 44 |
| Issue: | 8 |
| ISSN: | 0028-3878 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 1994-08-01 |
| Start Page: | 1473 |
| End Page: | 1479 |
| Language: | English |
| PROVIDER: | scopus |
| PUBMED: | 8058152 |
| DOI: | 10.1212/wnl.44.8.1473 |
| DOI/URL: | |
| Notes: | Export Date: 14 January 2019 -- Article -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
-
625Yahalom -
576De Angelis
Related MSK Work