Contributions
Abstract: PB1784
Type: Publication Only
Background
Primary non-Hodgkin's lymphomas occur in 3% of all brain tumors. This is a rare aggressive form of non-Hodgkin's lymphoma, localized in the brain, in the cerebral membranes, the spinal cord, in the orbit of the eyes.
Aims
The aim of the study is to evaluate five year overall and disease-free survival of patients with primary CNS lymphomas depending on the risk factors.
Methods
It is retrospective study of the 45 patients with primary lymphoma of the central nervous system (CNS) treated at the Kazakh Institute of Oncology and Radiology, from June 2006 to September 2016. The histological variants of the disease are presented in the form of diffuse large B-cell lymphoma in 28 patients, in the B-cell unspecified lymphoma in 16 patients, in the marginal zone - one patient. Mean age 48.4 (21-66). Women - 24 (53.3%), men – 21 (46.7%). Local forms – 15 (33,3%), advance forms - 30 (66,7%) of CNS lesion. The increase in LDH was registered in 32 patients. All patients received 3 cycles of chemotherapy (methotrexate 3.5 mg / m2 1d, cytarabine 2 g / m2 twice a day 2+3 d) with an interval of 21 days, following whole brain radiotherapy and for patients with PR adding boost for residual tumor.
Results
Complete response (CR) was achieved - 28 (62.2%), partial response (PR) -16 (35.5%), progressive disease (PD) -one (2.2%). The OS for all patients 48.9%, median was 21.6 months, SE 17.4, CI 95% (0 – 55.6). Patient performance status assessed by Karnovskiy scale before treatment 63.3, in the end of treatment 72.7. The recurrences of the disease were registered 21 patients (46.7%), the majority of patients were included in the unfavorable group on the Extranodal Lymphoma Study Group scale. Seventeen patients had a local recurrence, two - spinal cord recurrence. Recurrence-free median 24.6, SE 5.5, CI 95% (13.8 – 35.3). According to the Extranodal Lymphoma Study Group scale we have analyzed risks factors such as age, tumor lesion. It was presented that in the group of age > 50, OS 46.4%, median was 31.5 months, SE 4.2, CI 95% (23.4 – 39.7). Age < 50 OS 52.9%, median was 37.5 months, SE 10.8, CI 95% (16.3 – 58.7). For age risk factor differences not significant (χ2 = 0,2 р = 0,65). Recurrence for older than 50 years, and younger was 42.9% and 52.9% respectively, differences not significant (χ2 = 0,16 р = 0,69). In the local forms, OS 66.7%, median was not achieved yet. In that time advance forms OS 40.0%, median was 15.7 months, SE 5.3, CI 95% (5.3 – 26.0). For dissemination risk factor differences significant (χ2 = 5,2 р = 0,02). Recurrence for local and advance forms was 40% and 50% respectively, differences not significant (χ2 = 0,9 р = 0,34).
Infectious complications were diagnosed in seven patients. Neurological toxicity was observed in 12 patients, in the form of intense headaches, aggressive behavior and sleep disturbances after radiation therapy.
Conclusion
The analysis of the results obtained during chemotherapy for patients with primary CNS lymphoma, according to the prognostic factors (prevalence of the process, age), showed that relapses of the disease were more frequent in the group with unfavorable prognostic risk factors, the overall survival of patients in this group was lower than in a group with a favorable prognosis.
Session topic: 21. Aggressive Non-Hodgkin lymphoma - Clinical
Keyword(s): Lymphoma therapy, Recurrence
Abstract: PB1784
Type: Publication Only
Background
Primary non-Hodgkin's lymphomas occur in 3% of all brain tumors. This is a rare aggressive form of non-Hodgkin's lymphoma, localized in the brain, in the cerebral membranes, the spinal cord, in the orbit of the eyes.
Aims
The aim of the study is to evaluate five year overall and disease-free survival of patients with primary CNS lymphomas depending on the risk factors.
Methods
It is retrospective study of the 45 patients with primary lymphoma of the central nervous system (CNS) treated at the Kazakh Institute of Oncology and Radiology, from June 2006 to September 2016. The histological variants of the disease are presented in the form of diffuse large B-cell lymphoma in 28 patients, in the B-cell unspecified lymphoma in 16 patients, in the marginal zone - one patient. Mean age 48.4 (21-66). Women - 24 (53.3%), men – 21 (46.7%). Local forms – 15 (33,3%), advance forms - 30 (66,7%) of CNS lesion. The increase in LDH was registered in 32 patients. All patients received 3 cycles of chemotherapy (methotrexate 3.5 mg / m2 1d, cytarabine 2 g / m2 twice a day 2+3 d) with an interval of 21 days, following whole brain radiotherapy and for patients with PR adding boost for residual tumor.
Results
Complete response (CR) was achieved - 28 (62.2%), partial response (PR) -16 (35.5%), progressive disease (PD) -one (2.2%). The OS for all patients 48.9%, median was 21.6 months, SE 17.4, CI 95% (0 – 55.6). Patient performance status assessed by Karnovskiy scale before treatment 63.3, in the end of treatment 72.7. The recurrences of the disease were registered 21 patients (46.7%), the majority of patients were included in the unfavorable group on the Extranodal Lymphoma Study Group scale. Seventeen patients had a local recurrence, two - spinal cord recurrence. Recurrence-free median 24.6, SE 5.5, CI 95% (13.8 – 35.3). According to the Extranodal Lymphoma Study Group scale we have analyzed risks factors such as age, tumor lesion. It was presented that in the group of age > 50, OS 46.4%, median was 31.5 months, SE 4.2, CI 95% (23.4 – 39.7). Age < 50 OS 52.9%, median was 37.5 months, SE 10.8, CI 95% (16.3 – 58.7). For age risk factor differences not significant (χ2 = 0,2 р = 0,65). Recurrence for older than 50 years, and younger was 42.9% and 52.9% respectively, differences not significant (χ2 = 0,16 р = 0,69). In the local forms, OS 66.7%, median was not achieved yet. In that time advance forms OS 40.0%, median was 15.7 months, SE 5.3, CI 95% (5.3 – 26.0). For dissemination risk factor differences significant (χ2 = 5,2 р = 0,02). Recurrence for local and advance forms was 40% and 50% respectively, differences not significant (χ2 = 0,9 р = 0,34).
Infectious complications were diagnosed in seven patients. Neurological toxicity was observed in 12 patients, in the form of intense headaches, aggressive behavior and sleep disturbances after radiation therapy.
Conclusion
The analysis of the results obtained during chemotherapy for patients with primary CNS lymphoma, according to the prognostic factors (prevalence of the process, age), showed that relapses of the disease were more frequent in the group with unfavorable prognostic risk factors, the overall survival of patients in this group was lower than in a group with a favorable prognosis.
Session topic: 21. Aggressive Non-Hodgkin lymphoma - Clinical
Keyword(s): Lymphoma therapy, Recurrence