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Stereotactic Radiosurgery for Gynecologic Cancer
Published on: April 17, 2012
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Stereotactic Radiosurgery for Primary Central Nervous System Lymphoma.
Susan Y Wu1, Steve E Braunstein2, James L Rubenstein3
1Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
Cureus
|March 14, 2023
Summary
Stereotactic radiosurgery (SRS) provides excellent local control for primary central nervous system lymphoma (PCNSL). However, distant brain recurrence is common, highlighting the importance of systemic therapies for improving survival in PCNSL patients.
Area of Science:
- Neuro-oncology
- Radiation Oncology
- Medical Oncology
Background:
- Primary central nervous system lymphoma (PCNSL) is a rare malignancy.
- Standard treatment involves high-dose methotrexate chemotherapy, with radiation reserved for refractory or progressive disease.
- Stereotactic radiosurgery (SRS) is explored to defer or salvage whole brain radiotherapy (WBRT).
Purpose of the Study:
- To evaluate the outcomes of stereotactic radiosurgery (SRS) in patients with PCNSL.
- To assess SRS's role in deferring whole brain radiotherapy (WBRT) or as salvage therapy.
Main Methods:
- Retrospective review of 20 PCNSL patients treated with SRS between 1992 and 2019.
- Analysis of SRS dose, fraction, and patient characteristics (age, KPS, prior treatments).
- Evaluation of local control, distant recurrence, progression-free survival, and overall survival.
Main Results:
- 100% local control was achieved for 32 lesions treated with SRS.
- 81% of patients experienced distant brain recurrence, with a median time to failure of 10 months.
- Karnofsky Performance Status (KPS) at SRS correlated with time to progression (p=0.002).
- Consolidative lenalidomide/pomalidomide and etoposide/cytarabine improved overall survival.
Conclusions:
- SRS demonstrates effective local tumor control in PCNSL.
- Distant progression remains a significant challenge, necessitating effective systemic therapies.
- SRS may be valuable in the salvage setting or for deferring WBRT in select PCNSL patients.
