A comparison of survival of patients treated for AIDS-related central nervous system lymphoma with and without tissue diagnosis.
OBJECTIVE
This is a retrospective review of the treatment outcome of radiation therapy (RT) in acquired immune-deficiency syndrome (AIDS) patients with presumed primary central nervous system (CNS) non-Hodgkin's lymphoma (NHL), with and without tissue verification.


METHODS
Twenty-seven patients with AIDS-related CNS NHL were treated between 1986 and 1992. They were divided into two groups. Group 1 consisted of nine patients with a positive histology for NHL. They were treated with dexamethasone (DXM) and whole brain RT. Group 2 consisted of 18 patients who, because of unique circumstances, were treated without histologic confirmation of NHL. Rapid clinical and/or radiologic response to DXM and whole-brain RT was interpreted as NHL.


RESULTS
For group 1, the response rate was 87.5%, mean survival 6.1 months, and median survival 4.5 months. For group 2, the response rate was 72.2%, mean survival 5.2 months, and median survival 4.5 months. The overall response rate was 76.9%, mean survival 5.8 months, and median survival 4.5 months.


CONCLUSIONS
In instances where a tissue diagnosis cannot be established, a positive response to an empiric trial of DXM and RT to 20 Gy may constitute presumptive evidence of NHL.
Department of Radiation Oncology, New York Hospital-Cornell Medical Center, NY 10021, USA.
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T
Kaufmann
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LZ
Nisce
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M
Coleman
D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D003907:Dexamethasone / Q000627:therapeutic use; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D018931:Antineoplastic Agents, Hormonal; D003907:Dexamethasone