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J Korean Cancer Assoc > Volume 28(6); 1996 > Article
Journal of the Korean Cancer Association 1996;28(6): 1117-1126.
원발성 중추신경계 림프종의 방사선치료
우홍균, 김일한
Primary Central Nervous System Lymphoma ( PCNSL ) : Treatment Result
Hong Gyun Wu, Il Han Kim
This study analyzed the treatment results and the prognostic factors of PCNSL. Patients and
Surgical procedures were performed in 24 among 29 patients; 4 gross total removal, 9 subtotal removal, 11 open or stereotactic biopsy. Radiation fields include whole brain and reduced brain field. Whole spine field was used in 6 patients and local spinal field was used in 1 patient. The range of radiation dose to primary site was 4460 cGy to 5940 cGy with fractional dose of 180 cGy to 200 cGy. Systemic chemotherapy (6 cycles with CHOP) was used in 6 patients. Intrathecal methotrexate was used in 2 patient. Reeult: Follow-up range was 4 to 65 months. Median survival was 15 month and 2 year overall survival rate was 38%. Radiation dose and systemic chemotherapy were significant prognostic factors. Two year survival rate was 13% with dose less than 50 Gy, 49% with dose greater than or equal to 50 Gy (p=0.05). When the patients were treated radiation alone, 2 year survival rate was 27% and was 80% with radiation therapy combined with systemic chemotherapy (p=0.02).
At least, 50 Gy should be given to PCNSL. We could not find any benefit from the prophylactic whole spinal irradiation. Survival benefit with combined chemotherapy should be confirmed after long-term analysis.
Key words: Radiation therapy, Chemotherapy, Primary CNS lymphoma
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