Cranial Radiation Therapy as Salvage in the Treatment of Relapsed Primary CNS Lymphoma

Matthew E. Volpini, Jiheon Song, Rajiv Samant, David MacDonald, Vimoj J. Nair

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2 Citations (Scopus)

Résumé

Primary central nervous system lymphoma (PCNSL) is a rare malignancy. Standard of care is upfront high-dose methotrexate (HD-MTX) chemotherapy, while cranial radiation is more commonly used in the salvage setting. In this retrospective study, we aimed to investigate the safety and efficacy of salvage cranial radiation in PCNSL. PCNSL patients who received upfront HD-MTX chemotherapy and salvage cranial radiation after treatment failure between 1995 and 2018 were selected. Radiological response to cranial radiation was assessed as per Response Assessment in Neuro-Oncology Criteria. Twenty one patients were selected (median age 59.9 years), with median follow-up of 19.9 months. Fourteen patients (66.7%) received a boost to the gross tumour volume (GTV). Four patients (19.0%) sustained grade ≥2 treatment-related neurotoxicity post-completion of cranial radiation. Of the 19 patients who had requisite MRI with gadolinium imaging available for Response Assessment in Neuro-Oncology (RANO) criteria assessment, 47.4% achieved complete response, 47.4% achieved partial response, and 5.3% of patients exhibited stable disease. Higher dose to the whole brain (>30 Gy) was associated with higher rate of complete response (63.6%) than lower dose (≤30 Gy, 37.5%), while boost dose to the gross disease was also associated with higher rate of complete response (61.5%) compared with no boost dose (33.3%). Median overall survival was 20.0 months. PCNSL patients who relapsed following upfront chemotherapy showed a high rate of response to salvage cranial radiation, especially in those receiving greater than 30 Gy to the whole brain and boost to gross disease.

Langue d'origineEnglish
Pages (de-à)8160-8170
Nombre de pages11
JournalCurrent Oncology
Volume29
Numéro de publication11
DOI
Statut de publicationPublished - nov. 2022
Publié à l'externeOui

Note bibliographique

Publisher Copyright:
© 2022 by the authors.

ASJC Scopus Subject Areas

  • Oncology

PubMed: MeSH publication types

  • Journal Article

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