TY - JOUR
T1 - Primary spinal epidural lymphoma
T2 - Patients' profile, outcome, and prognostic factors: A multicenter Rare Cancer Network study
AU - Monnard, Virginie
AU - Sun, Alex
AU - Epelbaum, Ron
AU - Poortmans, Philip
AU - Miller, Robert C.
AU - Verschueren, Tom
AU - Scandolaro, Luciano
AU - Villa, Salvador
AU - Majno, Sabine Balmer
AU - Ostermann, Sandrine
AU - Ozsahin, Mahmut
AU - Mirimanoff, René Olivier
PY - 2006/7/1
Y1 - 2006/7/1
N2 - Purpose To assess the clinical profile, treatment outcome, and prognostic factors in primary spinal epidural lymphoma (PSEL). Methods and Materials Between 1982 and 2002, 52 consecutive patients with PSEL were treated in nine institutions of the Rare Cancer Network. Forty-eight patients had an Ann Arbor stage IE and four had a stage IIE. Forty-eight patients underwent decompressive laminectomy, all received radiotherapy (RT) with (n = 32) or without chemotherapy (n = 20). Median RT dose was 36 Gy (range, 6-50 Gy). Results Six (11%) patients progressed locally and 22 (42%) had a systemic relapse. At last follow-up, 28 patients were alive and 24 had died. The 5-year overall survival, disease-free survival, and local control were 69%, 57%, and 88%, respectively. In univariate analyses, favorable prognostic factors were younger age and complete neurologic response. Multivariate analysis showed that combined modality treatment, RT volume, total dose more than 36 Gy, tumor resection, and complete neurologic response were favorable prognostic factors. Conclusions Primary spinal epidural lymphoma has distinct clinical features and outcome, with a relatively good prognosis. After therapy, local control is excellent and systemic relapse occurs in less than half the cases. Combined modality treatment appears to be superior to RT alone.
AB - Purpose To assess the clinical profile, treatment outcome, and prognostic factors in primary spinal epidural lymphoma (PSEL). Methods and Materials Between 1982 and 2002, 52 consecutive patients with PSEL were treated in nine institutions of the Rare Cancer Network. Forty-eight patients had an Ann Arbor stage IE and four had a stage IIE. Forty-eight patients underwent decompressive laminectomy, all received radiotherapy (RT) with (n = 32) or without chemotherapy (n = 20). Median RT dose was 36 Gy (range, 6-50 Gy). Results Six (11%) patients progressed locally and 22 (42%) had a systemic relapse. At last follow-up, 28 patients were alive and 24 had died. The 5-year overall survival, disease-free survival, and local control were 69%, 57%, and 88%, respectively. In univariate analyses, favorable prognostic factors were younger age and complete neurologic response. Multivariate analysis showed that combined modality treatment, RT volume, total dose more than 36 Gy, tumor resection, and complete neurologic response were favorable prognostic factors. Conclusions Primary spinal epidural lymphoma has distinct clinical features and outcome, with a relatively good prognosis. After therapy, local control is excellent and systemic relapse occurs in less than half the cases. Combined modality treatment appears to be superior to RT alone.
KW - Chemotherapy
KW - Combined modality treatment
KW - Non-Hodgkin's lymphoma
KW - Primary spinal epidural lymphoma
KW - Radiation therapy
KW - Spinal cord compression
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U2 - 10.1016/j.ijrobp.2006.01.002
DO - 10.1016/j.ijrobp.2006.01.002
M3 - Article
C2 - 16542791
AN - SCOPUS:33646898509
SN - 0360-3016
VL - 65
SP - 817
EP - 823
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 3
ER -