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The Korean Journal of Medicine 2006;71(6): 654-661.
원저:원발성 중추신경계 림프종의 치료 성적에 대한 다기관 후향적 분석
Treatment outcomes of primary central nervous system lymphoma : Multi-center retrospective study
Joon Ho Moon
고려대학교 의과대학 내과학교실
Background : A primary central nervous system lymphoma (PCNSL) is a rare neoplasm with a poor prognosis. The treatment of PCNSL involves a combination of chemotherapy, intrathecal chemotherapy and radiotherapy. This study retrospectively evaluated the treatment outcomes and prognostic factors of Korean patients with PCNSL. Methods : Between 1995 and 2003, 58 patients diagnosed with PCNSL from the multi-center hospitals were enrolled in this study. Among 56 patients who had received treatment, 16 patients were treated with radiotherapy alone, while 40 patients were treated with combined chemotherapy (CHOP; 9 cases, high-dose methotrexate; 31 cases) and radiotherapy. Results : The median age of the patients was 58 years (range, 19-76). A diffuse large B-cell lymphoma was diagnosed in 56 cases (96.6%), while a peripheral T-cell lymphoma was diagnosed in 2 cases. Of the 47 patients who could be assessed for their response after treatment, a CR and PR was observed in 32 (68%) and 11 patients (23%), respectively, giving an overall response rate of 91% (95% CI, 82~100%). The estimated 3-year overall survival rate for all the patients was 67± 7.9% and the 3-year disease free survival rate was 53±8.3%. The overall survival of the high-dose methotrexate group was superior to that of the CHOP group (77±10% versus 47±19%, p=0.05). Leukoencephalopathy was observed as a late complication in 9 patients (21%). No significant prognostic factors affecting survival were found by univariate analysis. Conclusions : Approximately half of the patients could have long-term survival after treatment in this study. High-dose methotrexate containing chemotherapy followed by radiotherapy was found to be an effective treatment.(Korean J Med 71:654-661, 2006) Key Words : Lymphoma, Central Nervous System, CHOP, High-dose methotrexate, Radiotherapy
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