Effectiveness and limitation of gamma knife radiosurgery for relapsed central nervous system lymphoma: a retrospective analysis in one institution.
We describe 6 patients with relapsed central nervous system lymphoma (CNSL) treated with Gamma Knife radiosurgery (GKR). The histologic diagnosis in all 6 patients was diffuse large B-cell lymphoma without human immunodeficiency virus infection. Two patients had intracranial relapse of primary CNSL, and the remaining 4 had CNS relapse of systemic lymphoma. All patients were treated with GKR without severe adverse effects, and all but 1 patient received subsequent chemotherapy shortly after GKR. Four patients showed a complete response, and the remaining 2 patients had a partial response or stable disease. Although the neurologic symptoms disappeared or improved markedly in all patients, all of the diseases recurred or progressed 3 to 13 months after the first GKR. A second GKR was eventually performed in 4 patients. The median overall survival and progression-free survival times after the first GKR were 17 and 11 months, respectively. In our experience, GKR seems to be a useful procedure for the treatment of relapsed CNSL, because it facilitates excellent local control in a short-term treatment period without severe complications, although the efficacy period is not long enough.
Matsumoto
Yosuke
Y
Department of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan. yosuke-m@koto.kpu-m.ac.jp
Horiike
Shigeo
S
Fujimoto
Yoshiko
Y
Shimizu
Daisuke
D
Kudo-Nakata
Yuriko
Y
Kimura
Satoshi
S
Sato
Manabu
M
Nomura
Kenichi
K
Kaneko
Hiroto
H
Kobayashi
Yutaka
Y
Shimazaki
Chihiro
C
Taniwaki
Masafumi
M
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000000981:diagnostic imaging / Q000601:surgery*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016634:Radiosurgery; D012008:Recurrence; D012189:Retrospective Studies