Prognosis of primary central nervous system lymphoma treated with radiotherapy alone.

Purpose: Standard treatment for patients with primary central nervous system (CNS) lymphoma involves combining high-dose methotrexate-based chemotherapy and radiation. However, chemotherapy is sometimes contraindicated, and radiotherapy alone becomes the only option. We retrospectively investigated the clinical outcomes of primary CNS lymphoma patients treated with radiotherapy alone.

Materials And Methods: Between 1983 and 2006, 35 patients (median age 69 years, range 37-89 years) with primary CNS lymphoma were treated with radiotherapy alone. Of these, 74 % had an Eastern Cooperative Oncology Group performance status (PS) of 2-4. Most patients (91 %) received whole-brain irradiation with or without irradiation boost to the tumor site (median dose 50 Gy, range 22-50 Gy); remaining patients received partial brain irradiation.

Results: Median follow-up time was 20 (range 1-152) months, median survival time was 20 months, and the 1- and 2-year overall survival rates were 65 and 32 %, respectively. Median survival in patients aged <70 and ≥ 70 years was 26 and 10 months, respectively (p = 0.01).

Conclusion: Median survival with radiotherapy alone was 20 months. Patients aged <70 years have a better prognosis than those ≥ 70 years.