Clinical Characteristics And Prognosis Of 68 Primary Central Nervous System Lymphoma

ObjectiveThis study is aimed to analyze the clinical characteristics and the prognostic factors that influence on progression-free survival(PFS)and overall survival(OS)of patients newly diagnosed with PCNSL in our hospital.MethodsThe clinical datas of 68 patients diagnosed as PCNSL in of Fujian Medical University Union Hospital from 01 January 2010 to 01 november 2017 were analyzed retrospectively.Clinical features,laboratory examination,pathology,therapeutic regimen,curative effect and survival rate were recorded.All cases were risk-stratified by the IELSG(International Extranodal Lymphoma Study Group)scoring system,the MSKCC(Memorial Sloan-Kettering Cancer Center)scoring system and the new scoring system proposed by Jang et al,respectively.Clinical features,laboratory examination,pathology,therapeutic regimen were analyzed by univariate and multivariable.Results1.68 Cases of PCNSL patients,including 41 males and 27 females,in which the ratio of male:female was 1.5:1,the median age was 53 years(range:15-75years),32patients died and 36 patients stay alive.Brain hemispheres and basal ganglia were the mostly involved sites,the mean largest tumor volume was 29.27CM~3.Increased intracranial pressure was the major symptom,the median Karnofsky Performance Status(KPS)score was 80,the median Eastern Cooperative Oncology Group(ECOG)score was 1.All patients were EBV-negative and HIV-negative.95.59%Of PCNSL cases were Diffuse Large B-cell Lymphomas(DLBCL).Among the 68 PCNSL patients,65 patients were immunohistochemical,42 patients were Non-germinal center B-cell like(Non-GCB)subtype,accounting for 64.62%.23 Patients were Germinal center B-cell like(GCB)subtype,accounting for 35.38%.Therapeutic regimens varied greatly,58 patients received maximum lesion excision,accounting for 85.3%.55 Patients received chemotherapy,accounting for 80.88%.Average chemotherapy duration 5.5.51Patients received methotrexate-based therapy,accounting for 92.73%.22 Patients received chemotherapy including rituximab,accounting for 40%.14 Patients received chemotherapy including temozolomide,accounting for 25.45%.18 Patients received Intrathecal chemotherapy(IT-CT),accounting for 32.73%.21 Patients received radiotherapy,accounting for 30.88%.No patient received autologous stem cell transplantation(ASCT).2.The median PFS and OS of 68 PCNSL patients were 41.85 months and 43.60months respectively.The univariate analysis showed that:KPS score,MSKCC score,liverfunction afterchemotherapy,neutrophil,lymphocyte,infectionwere significantly associated with PFS.Multivariable analysis showed that:MSKCC score,neutrophil,infection were the independent prognostic factors for PFS.The univariate analysis showed that:KPS score,MSKCC score,a new scoring system proposed by Jang et al,albumin,postoperative treatment were significantly associated with OS.Multivariable analysis showed that:KPS score,albumin were the independent prognostic factors for OS.Conclusion1.This study showed that the morbidity of male was greater than female,the median age was 53 years,the proportion of Non-GCB is greater than GCB,the median KPS score was 80,the median ECOG score was 1,the median PFS and OS were 41.85months and 43.60 months respectively.2.MSKCC score,neutrophil,infection were the independent prognostic factors for PFS.KPS score,albumin were the independent prognostic factors for OS.3.The OS of chemotherapy combined or uncombined with radiotherapy regimen was significantly longer than that without chemotherapy or radiotherapy.