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M9460326.TXT
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1994-06-12
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Document 0326
DOCN M9460326
TI Radiotherapy of primary central nervous system lymphoma in patients with
and without human immunodeficiency virus. Ten years of treatment
experience at the University of California San Francisco.
DT 9408
AU Ling SM; Roach M 3rd; Larson DA; Wara WM; Department of Radiation
Oncology, University of California San; Francisco, San Francisco 94143.
SO Cancer. 1994 May 15;73(10):2570-82. Unique Identifier : AIDSLINE
MED/94228443
AB BACKGROUND. Classic human immunodeficiency virus (HIV) negative primary
central nervous system lymphoma (PCNSL) is a relatively uncommon
occurrence, whereas the incidence of HIV positive PCNSL has increased
dramatically during the past 5 years. Between 2% and 6% of all patients
with acquired immune deficiency syndrome (AIDS) will have PCNSL develop
clinically, and as many as 11% will have PCNSL found at autopsy. In the
United States, some of the earliest and most extensive experience with
HIV positive PCNSL has occurred in San Francisco. This article reports
on PCNSL in patients with and without HIV. METHODS. Using our
diagnosis-based computer retrieval system, we identified all patients
treated with radiotherapy for PCNSL between January 1982 and January
1992 and reviewed their medical records. Population characteristics,
risk factors and length of survival (LOS), were analyzed. Statistical
methodology included the Cox proportional hazards model and Kaplan-Meier
survival curves. RESULTS. Fifty-six patients were identified with PCNSL,
of which 41 were HIV positive and 15 were HIV negative. There was a
fourfold increase in the total number of PCNSL cases during the time
period 1987-1991 as compared with the preceding 5 years; these cases
primarily were in the HIV positive group. The average Karnofsky
performance score (KPS) in the HIV positive group was 50, whereas in the
HIV negative group, the KPS was 35. However, the median LOS in the HIV
positive group was 3 months, whereas in the HIV negative group it was 20
months. Within each group, there was a statistically significant
correlation between KPS and LOS. CONCLUSIONS. Patients with HIV and
PCNSL have a much shorter median LOS than do patients with PCNSL but
without HIV; however, the outcome for both groups is dismal. Randomized
clinical trials are needed to determine which patients with HIV might
benefit from more aggressive therapy and to determine the optimal choice
and dosages of chemoradiation therapy for patients with PCNSL without
HIV.
DE Adolescence Adult Aged Brain Neoplasms/MORTALITY/*RADIOTHERAPY
Female Human Lymphoma/MORTALITY/*RADIOTHERAPY Lymphoma,
AIDS-Related/MORTALITY/*RADIOTHERAPY Male Middle Age Proportional
Hazards Models Retrospective Studies Risk Factors JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).