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Purpose:Conventional therapy-i.e.,treatment with corticosteroids and cranial radiotherapy(RT)-is inadequate to treat AIDS-related primary central nervous system lymphoma(PCNSL),as it achieves a medial survival of only two to five 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 system 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 one 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. |
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acquired immunodeficiency syndrome
chemotherapy,CNS treatment and complications with
lymphoma
lymphoma involving CNS
lymphoma,primary of CNS
neoplasm,primary of CNS
neoplasm,primary of CNS-treatment of
radiation therapy,CNS treatment and complications with
treatment of neurologic disorder
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