Palliation of AIDS-related primary lymphoma of the brain: Observations from a multi-institutional database

被引:10
作者
Corn, BW
Donahue, BR
Rosenstock, JG
Cooper, JS
Xie, Y
Brandon, AH
Hegde, HH
Sherr, DL
Fisher, SA
Berson, A
Han, HK
Wahab, MA
Koprowski, CD
Ruffer, JE
Curran, WJ
机构
[1] THOMAS JEFFERSON UNIV HOSP,PHILADELPHIA,PA 19107
[2] PENN HOSP,PHILADELPHIA,PA 19107
[3] GRAD HOSP PHILADELPHIA,PHILADELPHIA,PA 19146
[4] HOSP UNIV PENN,PHILADELPHIA,PA 19104
[5] COOPER UNIV,MED CTR,CAMDEN,NJ
[6] NYU,NEW YORK,NY
[7] ST VINCENTS HOSP,NEW YORK,NY
[8] N SHORE UNIV HOSP,MANHASSET,NY
[9] UNIV MIAMI,MED CTR,MIAMI,FL 33152
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 1997年 / 38卷 / 03期
关键词
AIDS; palliative radiotherapy; PCNSL; lymphoma;
D O I
10.1016/S0360-3016(97)89486-2
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To catalogue the presenting symptoms of patients with AIDS who are presumed to have primary central nervous system lymphoma (PCNSL). To document the palliative efficacy of cranial irradiation (RT) relative to the endpoints of complete and overall response for the respective symptoms. Methods: An analysis of 163 patients with AIDS-related PCNSL who were evaluated at nine urban hospitals was performed. These patients were treated for PCNSL after the establishment of a tissue diagnosis or on a presumptive basis after failing empiric treatment for toxoplasmosis. All patients were treated between 1983 and 1995 with radiotherapy (median dose-fractionation scheme = 3 Gy x 10) and steroids (>90% dexamethasone). Because multiple fractionation schemes were used, prescriptions were converted to biologically effective doses according to the formula, Gy(10) = Total Dose x (1 + fractional dose/alpha-beta); using an (alpha-beta value of 10. Results: The overall palliative response rate for the entire group was 53%. In univariate analysis, trends were present associating complete response rates with higher performance status (KPS greater than or equal to 70 vs. KPS less than or equal to 60 = 17% vs. 5%), female gender (women vs. men = 29% vs. 8%), and the delivery of higher biologically effective doses (BED) of RT (Gy(10) > 39 vs. less than or equal to 39 = 20% vs. 5%). In multivariate analysis of factors predicting complete response, both higher KPS and higher BED retained independent significance. A separate univariate analysis identified high performance status (KPS greater than or equal to 70 vs, KPS less than or equal to 60 = 71% vs. 47%), and young age (less than or equal to 35 vs. > 35 = 61% vs. 40%) as factors significantly correlating with the endpoint of the overall response. In multivariate analysis, high performance status and the delivery of higher biologically effective doses of irradiation correlated significantly with higher overall response rates. Conclusion: Most AIDS patients who develop symptoms from primary lymphoma of the brain can achieve some palliation from a management program that includes cranial irradiation. Young patients with excellent performance status are most likely to respond to treatment. The delivery of higher biologically effective doses of irradiation also may increase the probability of achieving a palliative response. (C) 1997 Elsevier Science Inc.
引用
收藏
页码:601 / 605
页数:5
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