{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T21:15:16Z","timestamp":1696367716625},"reference-count":64,"publisher":"Walter de Gruyter GmbH","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,10,1]]},"abstract":"<jats:p>Background. Primary central nervous system lymphomas (PCNSL) are rare variants of extranodal non-Hodgkin\u2032s lymphomas that are nowadays primarily treated with high-dose methotrexate or methotrexate-based chemotherapy with or without radiation therapy. The optimal treatment of PCNSL is still unknown and there are differences in clinical practice.<\/jats:p>\n\t\t\t\t<jats:p>Patients and methods. With a retrospective research we evaluated our series of patients with PCNSL in regards to the patient\u2032s characteristics, treatment results, disease specific survival and overall survival. Fifty nine patients who attended the Institute of Oncology Ljubljana between 1995 and 2010 were treated according to the protocol that was valid at the time of the patient\u2032s admission. Between 1995 and 1999, the systemic treatment was classical CHOP (cyclophosphamide, doxorubicin, vincristine, steroids) chemotherapy, and later on high-dose methotrexate either alone or in combination with other agents. From 1999 onwards, radiation therapy was applied according to the patient\u2032s age and response to chemotherapy, prior to that all patients treated with CHOP were also irradiated. Patients ineligible for the systemic treatment were treated with sole radiation therapy.<\/jats:p>\n\t\t\t\t<jats:p>Results. There was a strong female predominance in our series and the median age at diagnosis was 59.8 years. Patients had predominantly aggressive B cell lymphomas (69.5%), one patient had marginal cell lymphoma and two patients T cell lymphoma. In total, 20.3% of patients were treated just with chemotherapy, 33.9% with combined therapy and 42.4% with sole radiation therapy. The overall response rate to the primary treatment in patients treated with sole chemotherapy was 33.3%, in patients treated with combined therapy 65% and in patients treated only with radiation therapy 56%, respectively. In terms of response duration, significantly better results were achieved with combined therapy or radiation therapy alone compared to sole chemotherapy (p&lt;0.0006). The median overall survival of the whole cohort was 11 months and the overall survival was significantly affected by the patient\u2032s age. The longest overall survival was observed in patients treated with combined therapy (median survival of 39 months). Patients treated just with radiation therapy had a median overall survival of 9 months and those treated with sole chemotherapy of 4.5 months, respectively.<\/jats:p>\n\t\t\t\t<jats:p>Conclusions. The treatment outcomes in ordinary clinical practice are definitely inferior to the ones reported in clinical trials. The now standard treatment with high-dose methotrexate with or without radiation therapy is sometimes too aggressive and, therefore, a careful selection on the basis of patient\u2032s age, performance status and concomitant diseases of those eligible for such treatment is mandatory. According to our results from a retrospective study, radiation therapy should not be excluded from the primary treatment.<\/jats:p>","DOI":"10.2478\/v10019-012-0048-5","type":"journal-article","created":{"date-parts":[[2013,2,15]],"date-time":"2013-02-15T09:01:33Z","timestamp":1360918893000},"page":"346-353","source":"Crossref","is-referenced-by-count":5,"title":["Treatment outcomes and survival in patients with primary central nervous system lymphomas treated between 1995 and 2010 \u2013 a single centre report"],"prefix":"10.2478","volume":"46","author":[{"given":"Barbara","family":"Jezersek Novakovic","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","reference":[{"key":"ref01","first-page":"1","article-title":"Temporal trends in incidence of primary brain tumors in the United States","author":"Hoffman","year":"2006"},{"key":"ref631","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/0360-3016(95)00207-F","article-title":"Primary central nervous system non lymphoma survival advantages with combined initial therapy","volume":"23","author":"Neill","year":"1995","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"ref811","first-page":"16","article-title":"Characteristics of long - 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agent methotrexate followed by irradiation in primary CNS lymphoma","volume":"18","author":"Brien","year":"2000","journal-title":"J Clin Oncol"},{"key":"ref191","first-page":"213","article-title":"Prophylactic cranial irradiation in patients with small - cell lung cancer : the experience at the Institute of Oncology Ljubljana","volume":"20","author":"Stanic","year":"2010","journal-title":"Radiol Oncol"},{"key":"ref451","first-page":"835","article-title":"Hochberg Primary central nervous system lymphoma","author":"Miller","year":"1988","journal-title":"J Neurosurg"},{"key":"ref181","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1023\/A:1008376412784","article-title":"Therapeutic management of primary central nervous system lymphoma : lessons from prospective trials","volume":"19","author":"Ferreri","year":"2000","journal-title":"Ann Oncol"},{"key":"ref221","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/0360-3016(95)00207-F","article-title":"Primary central nervous system non lymphoma survival advantages with combined initial therapy","volume":"23","author":"Neill","year":"1995","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"ref141","first-page":"110","article-title":"The potential for complete and durable response in nonglial primary brain tumors in children and young adults with enhanced chemotherapy delivery","volume":"15","author":"Dahlborg","year":"1998","journal-title":"Cancer J Sci Am"},{"key":"ref81","first-page":"257","article-title":"BE Clinical presentation and therapeutic outcome in patients with primary CNS lymphoma","volume":"26","author":"Herrlinger","year":"1998","journal-title":"Acta Neurol Scand"},{"key":"ref731","doi-asserted-by":"crossref","first-page":"188","DOI":"10.3171\/jns.1994.81.2.0188","article-title":"Preirradiation methotrexate chemotherapy of primary central nervous system lymphoma : Long - term outcome","author":"Glass","year":"1994","journal-title":"J Neurosurg"},{"key":"ref321","doi-asserted-by":"crossref","first-page":"188","DOI":"10.3171\/jns.1994.81.2.0188","article-title":"Preirradiation methotrexate chemotherapy of primary central nervous system lymphoma : Long - term outcome","author":"Glass","year":"1994","journal-title":"J Neurosurg"},{"key":"ref771","first-page":"37","article-title":"KV BP Central Cancer Treatment Group Whole - brain radiotherapy and high - dose methylprednisolone for elderly patients with primary central nervous system lymphoma : Results of North Central Cancer Treatment Group","volume":"96","author":"Laack","year":"2006","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"ref361","first-page":"37","article-title":"KV BP Central Cancer Treatment Group Whole - brain radiotherapy and high - dose methylprednisolone for elderly patients with primary central nervous system lymphoma : Results of North Central Cancer Treatment Group","volume":"96","author":"Laack","year":"2006","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"ref151","first-page":"71","article-title":"Combined systemic and intraventricular chemotherapy in primary CNS lymphoma : a pilot study","volume":"16","author":"Schlegel","year":"2001","journal-title":"J Neurol Psychiatry"},{"key":"ref761","first-page":"8315","article-title":"Non Hodgkin s lymphoma of the can high - dose large volume radiation therapy improve survival ? Report on a prospective trial by the Radiation Therapy Oncology Group","volume":"23","author":"Nelson","year":"1992","journal-title":"brain Int J Radiat Oncol Biol Phys"},{"key":"ref261","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1038\/sj.bjc.6605559","article-title":"Methotrexate area under the curve is an important outcome predictor in patients with primary CNS lymphoma pharmacokinetic - pharmacodynamic analysis from the IELSG no trial","volume":"27","author":"Joerger","year":"2010","journal-title":"Cancer"},{"key":"ref411","first-page":"1","article-title":"Temporal trends in incidence of primary brain tumors in the United States","author":"Hoffman","year":"2006"},{"key":"ref621","first-page":"153","article-title":"The diffuse large cell lymphoma - where do we stand now in everyday clinical practice","volume":"22","author":"Gregoric","year":"2012","journal-title":"Radiol Oncol"},{"key":"ref401","first-page":"16","article-title":"Characteristics of long - term survivors of brain metastases from lung cancer","author":"Niemiec","year":"2011","journal-title":"Rep Pract"},{"key":"ref431","first-page":"1958","article-title":"with clinical correlations of primary central nervous system non lymphoma The Massachusetts General Hospital experience","author":"Miller","year":"1994","journal-title":"Pathology Cancer"},{"key":"ref131","article-title":"Therapy of primary CNS lymphoma with methotrexate - based chemotherapy and deferred radiation therapy : preliminary results","volume":"14","author":"Cher","year":"1996","journal-title":"Neurology"},{"key":"ref551","first-page":"110","article-title":"The potential for complete and durable response in nonglial primary brain tumors in children and young adults with enhanced chemotherapy delivery","volume":"15","author":"Dahlborg","year":"1998","journal-title":"Cancer J Sci Am"},{"key":"ref331","first-page":"165","article-title":"Preliminary results of combined chemotherapy and radiotherapy for non - primary central nervous system lymphoma Group","author":"Brien","year":"1996","journal-title":"AIDS Trans Radiation Oncology Med"},{"key":"ref571","first-page":"976","article-title":"Primary cerebral non - Hodgkin lymphoma in non - immunocompromised subjects","volume":"17","author":"Blay","year":"1997","journal-title":"Cancer"},{"key":"ref391","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1200\/JCO.2000.18.3.519","article-title":"Phase II multicenter study of brief single - agent methotrexate followed by irradiation in primary CNS lymphoma","volume":"18","author":"Brien","year":"2000","journal-title":"J Clin Oncol"},{"key":"ref61","first-page":"199","article-title":"of primary lymphoma","author":"Schabet","year":"1999","journal-title":"Epidemiology"},{"key":"ref671","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1038\/sj.bjc.6605559","article-title":"Methotrexate area under the curve is an important outcome predictor in patients with primary CNS lymphoma pharmacokinetic - pharmacodynamic analysis from the IELSG no trial","volume":"27","author":"Joerger","year":"2010","journal-title":"Cancer"},{"key":"ref161","first-page":"976","article-title":"Primary cerebral non - Hodgkin lymphoma in non - immunocompromised subjects","volume":"17","author":"Blay","year":"1997","journal-title":"Cancer"},{"key":"ref301","first-page":"219","article-title":"Primary central nervous system lymphoma : from clinical presentation to diagnosis","volume":"31","author":"Herrlinger","year":"1999"},{"key":"ref541","article-title":"Therapy of primary CNS lymphoma with methotrexate - based chemotherapy and deferred radiation therapy : preliminary results","volume":"14","author":"Cher","year":"1996","journal-title":"Neurology"},{"key":"ref461","doi-asserted-by":"crossref","first-page":"39","DOI":"10.2478\/v10019-007-0037-2","article-title":"Solid tumors in young children in Moscow Region of Russian Federation","volume":"42","author":"Kachanov","year":"2008","journal-title":"Radiol Oncol"},{"key":"ref651","article-title":"multicenter study of treatment of primary CNS lymphoma","volume":"25","author":"Ferreri","year":"2002","journal-title":"Neurology"},{"key":"ref681","doi-asserted-by":"crossref","first-page":"5034","DOI":"10.1200\/JCO.2005.13.524","article-title":"Report of an international workshop to standardize baseline evaluation and response criteria for primary CNS lymphoma","volume":"28","author":"Abrey LE","year":"2005","journal-title":"J Clin Oncol"},{"key":"ref581","first-page":"537","article-title":"Pech IV JG for tumors","volume":"18","author":"Peterson","year":"1998","journal-title":"Chemotherapy brain Oncology"},{"key":"ref531","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1200\/JCO.1998.16.3.859","article-title":"Long - term survival in primary CNS lymphoma","volume":"13","author":"Abrey LE","year":"1998","journal-title":"J Clin Oncol"},{"key":"ref121","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1200\/JCO.1998.16.3.859","article-title":"Long - term survival in primary CNS lymphoma","volume":"13","author":"Abrey LE","year":"1998","journal-title":"J Clin Oncol"},{"key":"ref491","first-page":"257","article-title":"BE Clinical presentation and therapeutic outcome in patients with primary CNS lymphoma","volume":"26","author":"Herrlinger","year":"1998","journal-title":"Acta Neurol Scand"},{"key":"ref271","doi-asserted-by":"crossref","first-page":"5034","DOI":"10.1200\/JCO.2005.13.524","article-title":"Report of an international workshop to standardize baseline evaluation and response criteria for primary CNS lymphoma","volume":"28","author":"Abrey LE","year":"2005","journal-title":"J Clin Oncol"},{"key":"ref311","first-page":"161","article-title":"Systemic chemotherapy with vincristine cyclophosphamide doxorubicin and prednisolone following radiotherapy for primary central nervous system lymphoma : a phase II study","author":"Shibamoto","year":"1999"},{"key":"ref751","first-page":"374","article-title":"High - dose cytarabine plus high - dose methotrexate versus high - dose methotrexate alone in patients with primary CNS lymphoma : a randomised phase trial","volume":"20","author":"Ferreri","year":"2009","journal-title":"Lancet"},{"key":"ref601","first-page":"213","article-title":"Prophylactic cranial irradiation in patients with small - cell lung cancer : the experience at the Institute of Oncology Ljubljana","volume":"20","author":"Stanic","year":"2010","journal-title":"Radiol Oncol"},{"key":"ref341","first-page":"374","article-title":"High - dose cytarabine plus high - dose methotrexate versus high - dose methotrexate alone in patients with primary CNS lymphoma : a randomised phase trial","volume":"20","author":"Ferreri","year":"2009","journal-title":"Lancet"},{"key":"ref351","first-page":"8315","article-title":"Non Hodgkin s lymphoma of the can high - dose large volume radiation therapy improve survival ? Report on a prospective trial by the Radiation Therapy Oncology Group","volume":"23","author":"Nelson","year":"1992","journal-title":"brain Int J Radiat Oncol Biol Phys"},{"key":"ref521","first-page":"213","article-title":"conformal radiotherapy with concomitant and adjuvant temozolomide for patients with glioblastoma multiforme and evaluation of prognostic factors","volume":"12","author":"Tezcan","year":"2011","journal-title":"Radiol Oncol"},{"key":"ref111","first-page":"213","article-title":"conformal radiotherapy with concomitant and adjuvant temozolomide for patients with glioblastoma multiforme and evaluation of prognostic factors","volume":"12","author":"Tezcan","year":"2011","journal-title":"Radiol Oncol"},{"key":"ref641","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1200\/JCO.1996.14.2.556","article-title":"Preirradiation chemotherapy with cyclophosphamide doxorubicin vincristine and dexamethasone for primary CNS lymphomas : initial report of radiation therapy oncology group protocol","volume":"24","author":"Schultz","year":"1996","journal-title":"J Clin Oncol"}],"container-title":["Radiology and Oncology"],"original-title":[],"link":[{"URL":"http:\/\/content.sciendo.com\/view\/journals\/raon\/46\/4\/article-p346.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/view\/j\/raon.2012.46.issue-4\/v10019-012-0048-5\/v10019-012-0048-5.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,5,30]],"date-time":"2020-05-30T18:37:08Z","timestamp":1590863828000},"score":1,"resource":{"primary":{"URL":"https:\/\/content.sciendo.com\/doi\/10.2478\/v10019-012-0048-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,10,1]]},"references-count":64,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.2478\/v10019-012-0048-5","relation":{},"ISSN":["1581-3207","1318-2099"],"issn-type":[{"value":"1581-3207","type":"electronic"},{"value":"1318-2099","type":"print"}],"subject":[],"published":{"date-parts":[[2012,10,1]]}}}