Outcome and Prognostic Factors of Primary Central Nervous System Lymphoma in Southern Thailand.

Abstract

Context:Primary central nervous system lymphoma (PCNSL) is an uncommon type of brain tumor that has an aggressive disease course. Its outcomes, including factor-related outcomes, are therefore not well established in our country.Aims:This study aims to investigate the outcome and prognostic factors in PCNSL patients at our institute.Settings and Design:Retrospective study in a single university hospital.Subjects and Methods:We reviewed consecutive cases of newly diagnosed PCNSL at Prince of Songkla University from 2005 to 2018. The data were collected to evaluate the treatment outcomes and prognostic factors.Statistical Analysis Used:The Kaplan–Meier method for survival analysis, and Cox regression for variable analysis.Results:Eighty-seven patients met the inclusion criteria. Patients were predominantly male, and their mean age was 58.8 ± 11.2 years. Only four patients were infected with HIV. Motor weakness was the most common presentation, and neuroimaging revealed multiple lesions in 56.3% of patients. The patients were divided into four groups according to treatment modality: palliative treatment, whole-brain radiotherapy (WBRT) alone, chemotherapy (CMT) alone, and combined WBRT and CMT groups. The median overall survival was 7 months. The 1-, 2-, and 5-year survival rates were 29%, 21.5%, and 4.6%, respectively. The age of >60 years was a significant poor prognostic factor. In addition, patients who received combined treatment exhibited the highest survival rate.Conclusions:PCNSL has a low survival rate, even in the present era. Older age is the most substantial factor associated with unfavorable outcomes. The most effective treatment is combined with WBRT and CMT.