Second-line treatment for primary central nervous system lymphoma

Summary Failure after first-line treatment was reported in 35–60% of immunocompetent patients with primary central nervous system lymphoma (PCNSL). There are currently no reports focusing on salvage therapy. This review analyses prognostic factors and the efficacy of salvage therapy by focusing on d...

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Bibliographic Details
Published in:British journal of cancer 1999-02, Vol.79 (3-4), p.530-534
Main Authors: Reni, M, Ferreri, A J M, Villa, E
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Biomedical and Life Sciences
Biomedicine
Cancer Research
Central Nervous System Neoplasms - therapy
Disease Progression
Drug Resistance
Epidemiology
Female
Hematologic and hematopoietic diseases
Humans
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Lymphoma, Non-Hodgkin - therapy
Male
Medical sciences
Middle Aged
Molecular Medicine
Neoplasm Recurrence, Local
Oncology
Prognosis
Quality of Life
Regular
regular-article
Salvage Therapy
Survival Analysis
Treatment Outcome
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Summary:Summary Failure after first-line treatment was reported in 35–60% of immunocompetent patients with primary central nervous system lymphoma (PCNSL). There are currently no reports focusing on salvage therapy. This review analyses prognostic factors and the efficacy of salvage therapy by focusing on data from papers reporting results of first-line treatment in 355 cases. The study group consisted of 173 patients presenting treatment failure. The interval between failure and death (TTD) was compared for age at relapse (≤60 vs >60 years), type of failure (relapse vs progression), time to relapse (≤12 vs >12 months) and salvage treatment (yes vs no). Median TTD was similar in younger and older patients ( P = 0.09). Relapsed patients had a longer TTD than patients with progressive disease ( P = 0.002). Early relapse led to a shorter TTD than late relapse ( P = 0.005). Median TTD was 14 months for patients who underwent salvage therapy and 2 months for untreated cases ( P < 0.00001). A multivariate analysis showed an independent prognostic role for salvage therapy and time to relapse. Age and type of failure had no predictive value. Salvage therapy significantly improves outcome and, possibly, quality of life. As many different treatments were used conclusions cannot be made regarding an optimal treatment schedule.
ISSN:0007-0920
1532-1827
DOI:10.1038/sj.bjc.6690083