NON-HODGKINS-LYMPHOMA OF THE BRAIN - CAN HIGH-DOSE, LARGE VOLUME RADIATION-THERAPY IMPROVE SURVIVAL - REPORT ON A PROSPECTIVE TRIAL BY THE RADIATION-THERAPY-ONCOLOGY-GROUP (RTOG) - RTOG-8315
NON-HODGKINS-LYMPHOMA OF THE BRAIN - CAN HIGH-DOSE, LARGE VOLUME RADIATION-THERAPY IMPROVE SURVIVAL - REPORT ON A PROSPECTIVE TRIAL BY THE RADIATION-THERAPY-ONCOLOGY-GROUP (RTOG) - RTOG-8315
复制标题
DOI：
10.1016/0360-3016(92)90538-s
复制
发表时间：
1992-01-01
影响因子：
7
通讯作者：
MURRAY, KJ
中科院分区：
文献类型：
--
作者：
NELSON, DF;MARTZ, KL;MURRAY, KJ
1983 年至 1987 年间，放射治疗肿瘤学组进行了一项前瞻性 II 期研究，以评估接受 40 Gy 全脑照射和 20 Gy 肿瘤加 2 cm 边缘照射的原发性非霍奇金淋巴瘤的生存率。 据报告有四十一名患者。 对 35/41 的死亡者进行全面随访。 放射治疗开始后，6 名患者的存活时间为 8.8-67.2 个月，中位随访时间为 53.9 个月。 放射治疗开始后的总体中位生存期为 11.6 个月，诊断后的中位生存期为 12.2 个月，其中 48% 的患者存活 1 年，28% 的患者存活 2 年。 卡诺夫斯基表现状态和年龄是重要的预后因素。 卡诺夫斯基体能状态为 70-100 的患者的中位生存期为 21.1 个月，而卡诺夫斯基体能状态为 40-60 的患者的中位生存期为 5.6 个月 (p < .001)。 14 名 < 60 岁患者的中位生存期为 23.1 个月，而 27 名大于或等于 60 岁的患者的中位生存期为 7.6 个月（对数秩 p = .001）。 25/41 (61%) 的患者出现脑部疾病复发（21/41 仅出现在脑部，4/41 出现在脑部加上远处转移）。 尽管进行高剂量和大体积照射，原发性中枢神经系统淋巴瘤仍然表现出过高的死亡率，特别是在老年患者中。 原发性中枢神经系统淋巴瘤相对放射抗性的这一悖论仍未得到解决。
Between 1983 and 1987 the Radiation Therapy Oncology Group conducted a prospective phase II study to evaluate survival in primary non-Hodgkin's lymphoma of the brain treated with whole brain irradiation to 40 Gy and a 20 Gy boost to tumor plus a 2 cm margin. Forty-one patients are reported. Full follow-up is available on 35/41 who have died. Six are alive at 8.8-67.2 months from start of radiation therapy with a median followup of 53.9 months. Overall median survival was 11.6 months from start of radiation therapy and 12.2 months from diagnosis, with 48% surviving 1 year and 28% surviving 2 years. Karnofsky Performance Status and age were significant prognostic factors. Patients with a Karnofsky Performance Status of 70-100 had a median survival of 21.1 months compared to 5.6 months for patients with a status of 40-60 (p < .001). Fourteen patients < 60 years of age had a median survival of 23.1 months, while 27 patients greater-than-or-equal-to 60 years of age had a median survival of 7.6 months (log-rank p = .001). Disease recurred in the brain in 25/41 (61%) of the patients, (21/41 in the brain only and 4/41 in the brain plus distant metastases). Despite high dose and large volume irradiation, primary Central Nervous System lymphoma still exhibits excessive mortality, especially in older patients. This paradox of the relative radioresistance of primary Central Nervous System lymphoma remains unresolved.