Clinical Predictors and Recurrence Characteristics Following Radiotherapy for Primary Central Nervous System...

Area of Science:

• Neuro-oncology
• Radiation Oncology

Background:

• Primary central nervous system lymphoma (PCNSL) is a rare, aggressive brain tumor predominantly affecting older adults.
• Radiotherapy (RT) is a key treatment for PCNSL, especially for patients unable to receive systemic chemotherapy.

Purpose of the Study:

• To identify prognostic factors influencing survival in PCNSL patients treated with RT.
• To evaluate recurrence patterns following radiotherapy in a real-world cohort.

Main Methods:

• Retrospective analysis of 64 PCNSL patients treated with RT between 2000-2022.
• Chart review for clinical data, treatment details, and outcomes.
• Kaplan-Meier and Cox regression for overall survival (OS) analysis; imaging assessment for recurrence patterns.

Main Results:

• Median OS was 10 months; median patient age was 71 years, with 53.1% having ECOG performance status ≥2.
• Negative prognostic factors for OS included older age, poor performance status, seizures, no systemic therapy, and <80% of planned RT dose.
• Of 29 patients with follow-up imaging, 8 recurrences were noted, all within previously irradiated areas.

Conclusions:

• Confirms known negative prognostic factors in PCNSL and highlights the necessity of systemic chemotherapy for improved survival.
• Recurrence patterns suggest that whole-brain irradiation may not significantly prevent distant relapses.
• Findings support prospective trials to optimize RT strategies, balancing efficacy and neurotoxicity.