Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Novalis Radiosurgery of Primary Central Nervous System Lymphoma in Elderly Patients : Preliminary Results

  • Han, Seong-Rok (Departments of Neurosurgery, Ilsan Paik Hospital, College of Medicine, Inje University) ;
  • Yee, Gi-Taek (Departments of Neurosurgery, Ilsan Paik Hospital, College of Medicine, Inje University) ;
  • Choi, Chan-Young (Departments of Neurosurgery, Ilsan Paik Hospital, College of Medicine, Inje University) ;
  • Sohn, Moon-Jun (Departments of Neurosurgery, Ilsan Paik Hospital, College of Medicine, Inje University) ;
  • Lee, Dong-Joon (Departments of Neurosurgery, Ilsan Paik Hospital, College of Medicine, Inje University) ;
  • Whang, Choong-Jin (Departments of Neurosurgery, Ilsan Paik Hospital, College of Medicine, Inje University)
  • Published : 2006.06.30
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Abstract

Objective : Primary central nervous system lymphoma[PCNSL] is a non-Hodgkin's lymphoma arising in the central nervous system. Combined chemotherapy and radiation therapy is the standard treatment for PCNSL. However, treatment induced neurotoxicity is a major problem especially in elderly patients. Methods : From May 2001 to April 2004, elderly five patients with PCNSL confirmed via pathological examination were underwent Novalis radiosurgery in authors' institution, who were investigated retrospectively. Of these patients, 2 were male and 3 were female, with a mean age 68 years old [range $65{\sim}73$]. The number of lesions was 1 in 2 patients, 2 in 2, and 3 in 1. The mean follow up period was 12.6 months [range $8{\sim}16$]. Results : Clinical symptoms and signs in all patients markedly improved within 1 weeks after Novalis radiosurgery. The Karnofsky performance status score was also improved from a pre-radiosurgery average of 68 to a post-radiosurgery one of 82. All of treated lesions showed a partial or complete regression of the original mass. There have been no complication following Novalis radiosurgery. Conclusion : The preliminary results of our experience indicate that radiosurgery with Novalis provides a safe and effective therapeutic alternative treatment of PCNSL in elderly patients.

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References

  1. Abrey LE, DeAngelis LM, Yahalom J : Long-term survival in primary CNS lymphoma. J Clin Oncol 16 : 859-863, 1998 https://doi.org/10.1200/JCO.1998.16.3.859
  2. Bataille B, Delwail V, Menet E, Vandermarcq P, Ingrand P, Wager M, et al : Primary intracerebral malignant lymphoma : report of 248 cases. J Neurosurg 92 : 261-266, 2000 https://doi.org/10.3171/jns.2000.92.2.0261
  3. Bellinzona M, Roser F, Ostertag H, Gaab RM, Saini M : Surgical removal of primary central nervous system lymphomas(PCNSL) presenting as space occupying lesion : a series of 33 cases. Eur J Surg Oncol 31 : 100-105, 2005 https://doi.org/10.1016/j.ejso.2004.10.002
  4. Depil S, Coiteux V, Guillerm G, Gyan E, Bauters F, Fenaux P, et al : Primary central nervous system lymphoma in immunocompetent adults : poor results mainly associated with high treatment related toxicities. Leuk Lymphoma 43 : 1819-1822, 2002 https://doi.org/10.1080/1042819021000006420
  5. Dong Y, Pan L, Wang B, Wang E, Zhang N, Cai P, et al : Streotactic radiosurgery in the treatment of primary central nervous system lymphoma. Chin Med J 116 : 1166-1170, 2003
  6. Freilich RJ, Delattre JY, Monjour A, DeAngelis LM : Chemotherapy without radiation therapy as initial treatment for primary CNS lymphoma in older patients. Neurology 46 : 436-439, 1996
  7. Hodson DJ, Bowles KM, Cooke LJ, Klager SL, Powell GA, Laing RJ, et al : Primary central nervous system lymphoma : a single-centre experience of 55 unselected cases. Clin Oncol (R Coll Radiol) 17 : 185-191, 2005 https://doi.org/10.1016/j.clon.2004.10.007
  8. Kim IM, Lee CY, Son EI, Kim DW, Yim MB, Kim SP : Treatment strategies for primary central nervous system lymphoma. J Korean Neurosurg Soc 30 : 334-341, 2001
  9. Nelson DF : Radiotherapy in the treatment of primary central nervous system lymphoma(PCNSL). J Neurooncol 43 : 241-247, 1999 https://doi.org/10.1023/A:1006206602918
  10. Tomlison FH, Kurtin PJ, Suman VJ, Scheithauer BW, O'Fallon JR, Kelly PJ, et al : Primary intracerebra malignant lymphoma : a clinicopathological study of 89 patients. J Neurosurg 82 : 558-566, 1995 https://doi.org/10.3171/jns.1995.82.4.0558
  11. Wu HG, Kim IH, Ha SW, Park CI, Bang YJ, Huh DS : Survival improvement with combined radio-chemotherapy in the primary central nervous system lymphomas. J Korean Med Sci 14 : 565-570, 1999 https://doi.org/10.3346/jkms.1999.14.5.565
  12. Yamanaka R, Tanaka R : Advances for the treatment of primary central nervous system lymphoma (review). Oncol Rep 12 : 563-568, 2004
  13. Campbell PG, Jawahar A, Fowler MR, DeLaune A, Nanda A : Primary central nervous system lymphoma of the brain stem responding favorably to radiosurgery : a case report and literature review. Surg Neurol 64 : 400-405, 2005 https://doi.org/10.1016/j.surneu.2004.12.028
  14. Lai R, Rosenblum MK, DeAngelis LM : Primary CNS lymphoma : a whole-brain disease? Neurology 59 : 1557-1562, 2002 https://doi.org/10.1212/01.WNL.0000034256.20173.EA
  15. Nelson DF : Radiotherapy in the treatment of primary central nervous system lymphoma. J Neurooncol 43 : 241-247, 1999 https://doi.org/10.1023/A:1006206602918
  16. Sakamoto M, Oya N, Mizowaki T, Araki N, Nagata Y, Takayama K, et al : Initial experiences of palliative stereotactic radiosurgery for recurrent brain lymphomas. J Neurooncol 2005 Sep 16 [Epub ahead of print]