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M9490375.TXT
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1994-09-19
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Document 0375
DOCN M9490375
TI Combined-modality therapy in the treatment of primary central nervous
system lymphoma in AIDS.
DT 9411
AU Forsyth PA; Yahalom J; DeAngelis LM; Department of Neurology, Memorial
Sloan-Kettering Cancer Center,; New York, NY.
SO Neurology. 1994 Aug;44(8):1473-9. Unique Identifier : AIDSLINE
MED/94336022
AB PURPOSE: Conventional therapy--ie, treatment with corticosteroids and
cranial radiotherapy (RT)--is inadequate to treat AIDS-related primary
central nervous system lymphoma (PCNSL), as it achieves a median
survival of only 2 to 5 months. Chemotherapy added to RT in non-AIDS
PCNSL improves disease control and prolongs survival. We studied the
efficacy of this approach with RT in AIDS-related PCNSL. METHODS: Ten
AIDS patients with PCNSL were treated with chemotherapy--nine at
diagnosis and one at recurrence. None had evidence of systemic lymphoma.
All patients treated at diagnosis received pre-RT methotrexate--eight
also received thiotepa and procarbazine--followed by whole-brain RT. The
patient treated at recurrence (who had been previously irradiated)
received chemotherapy alone, including methotrexate, thiotepa, and
procarbazine. RESULTS: All had enhancing lesions on MRI and five (50%)
had a single lesion (seven [70%] had a ring-enhancing mass). No patient
had a response to corticosteroids. Four of seven (57%) assessable
patients had a partial or complete response to chemotherapy prior to RT.
Six of seven (86%) assessable patients had a complete response at the
end of treatment. Median survival was 3.5 months for all 10 patients and
7 months for the eight patients who completed therapy. Two patients
survived for 1 year or longer. Eight patients died--six from infection
(two treatment-related), one from progressive dementia, and one from a
gastrointestinal hemorrhage. CONCLUSION: AIDS-related PCNSL responds to
chemotherapy and RT, but only a few patients benefit with prolonged
survival.
DE Adult Antineoplastic Agents/*THERAPEUTIC USE Brain/PATHOLOGY Central
Nervous System Neoplasms/PHYSIOPATHOLOGY/*THERAPY Combined Modality
Therapy Cranial Irradiation Female Human Lymphoma,
AIDS-Related/PHYSIOPATHOLOGY/*THERAPY Magnetic Resonance Imaging Male
Middle Age Neoplasm Recurrence, Local JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).