Primary spinal epidural lymphoma: patients' profile, outcome, and prognostic factors: a multicenter Rare Cancer Network study.
OBJECTIVE
To assess the clinical profile, treatment outcome, and prognostic factors in primary spinal epidural lymphoma (PSEL).


METHODS
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.
Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Virginie
V
Monnard
Alex
A
Sun
Ron
R
Epelbaum
Philip
P
Poortmans
Robert C
RC
Miller
Tom
T
Verschueren
Luciano
L
Scandolaro
Salvador
S
Villa
Sabine Balmer
SB
Majno
Sandrine
S
Ostermann
Mahmut
M
Ozsahin
René-Olivier
RO
Mirimanoff
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000379:methods; D004824:Epidural Space; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000209:etiology; D011879:Radiotherapy Dosage; D013125:Spinal Neoplasms / Q000401:mortality / Q000628:therapy*; D016019:Survival Analysis; D016896:Treatment Outcome