PRIMARY LYMPHOMA OF BRAIN - RESULTS OF MANAGEMENT OF A MODERN COHORT WITH RADIATION-THERAPY

Purpose: To assess the outcome and prognostic factors for patients wit h primary lymphoma of brain managed with radiation therapy between 197 9 and 1988. Methods and materials: A retrospective review was undertak en of 49 patients referred to Princess Margaret Hospital. There were 2 5 males and 24 females. Median age was 60 years, with a range of 17-80 years. Tumors were located supratentorially in 35, infratentorially i n 10, and both in 4 patients. Single masses were demonstrated on CT br ain in 36, and multiple lesions in 13 patients. Cranial irradiation wa s given in 48, and 11 patients received chemotherapy. All patients in this series were immunocompetent. Results: Over a follow-up range of 3 -11 years of surviving patients, with a median of 6 years, 40/49 patie nts have died. Overall median survival was 1.4 years (17 months) and 5 -year actuarial survival was 26%. Statistical analysis revealed the fo llowing significant factors: Karnofsky performance status (KPS), age, and distribution pattern of disease on presenting CT brain. Five-year actuarial survival for patients with a KPS > 60 or < 60 was 56% and 10 %, respectively (P = 0.01); for patients with age < 60 or > 60, 5-year actuarial survival was 42% and 9%, respectively (P = 0.03); for patie nts with solitary or multiple lesions, 5-year actuarial survival was 3 0% and 15%, respectively (P = 0.04).Conclusions: We conclude that Karn ofsky performance status, age, and distribution pattern on pretreatmen t CT of brain are significant prognostic factors in primary lymphoma o f brain, and that new approaches need to be developed for these patien ts. (C) 1997 Elsevier Science Ireland Ltd.