title: Additional experience with empiric radiotherapy for presumed human immunodeficiency virus-associated primary central nervous system lymphoma.
abstract: BACKGROUND
  In light of the steadily improving capability to treat opportunistic infections, the authors reviewed their recent experience with short course empiric radiotherapy for the treatment of human immunodeficiency virus (HIV)-associated presumed central nervous system (CNS) lymphoma.
  
  
  METHODS
  Medical records were reviewed of 32 previously unreported HIV-infected patients who had computed tomography and/or magnetic resonance imaging findings consistent with lymphoma, whose lesions had failed to respond to antitoxoplasmosis therapy and therefore subsequently treated with empiric radiotherapy to the cranium and meninges, nearly always 3000 cGy in 10 fractions.
  
  
  RESULTS
  The majority of patients were in poor general condition (median Karnofsky score = 50) when radiotherapy was initiated. Fifty percent improved during or after radiation. Median survival was 2.1 months.
  
  
  CONCLUSIONS
  Despite progress made in the past several years in the treatment of opportunistic infections and brief clinical response to radiotherapy, patients with acquired immunodeficiency syndrome who have a presumed diagnosis of CNS lymphoma continue to have extremely poor survival. Early biopsy in patients with lesions that fail to respond to empiric antitoxoplasmosis treatment or with lesions radiographically most consistent with lymphoma may improve outcome.
authors.affiliation: Division of Radiation Oncology, New York University Medical Center, New York 10016, USA.
authors.forename: B R
authors.initials: BR
authors.lastname: Donahue
authors.forename: J W
authors.initials: JW
authors.lastname: Sullivan
authors.forename: J S
authors.initials: JS
authors.lastname: Cooper
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000532:radiotherapy*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D016867:Immunocompromised Host; D008223:Lymphoma / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed