Consideration of aggressive therapeutic strategies for primary testicular lymphoma.
To evaluate the clinical features and treatment of primary testicular lymphoma, 45 cases were retrospectively evaluated. The median age of the patients was 59 years (range, 40-81) and most patients (76%) presented with Stages I-II. All patients underwent an orchiectomy, after which various treatments were given, chemotherapy alone in 37 patients (60%) and chemotherapy with involved field radiotherapy (IFRT) in 15 patients (33%). Prophylactic intrathecal chemotherapy was given to six patients; cranial irradiation was given in two patients. Eleven patients (24%) received prophylactic irradiation or surgery on the contralateral testis. In 40 patients able to be evaluated, complete response (CR) rate was 78%; 11 of 31 CR patients (36%) had relapsed. Relapse or disease progression was observed in 21 patients. The most frequent site (44%) was in the CNS. The median progression free survival and overall survival were 16 and 34 months, respectively. Ten patients who received prophylactic radiation to the contralateral testis had no relapse in this site. In six patients who received prophylactic intrathecal chemotherapy, there was no leptomeningeal progression, but brain parenchymal relapse occurred in two patients. In multivariate analysis, Stage I (P = 0.02) and additional IFRT after orchiectomy (P = 0.01) were found to be good prognostic factors. In conclusion, orchiectomy followed by intensive chemotherapy and IFRT including prophylaxis to the CNS and contralateral testis, should be considered as initial treatment in primary testicular lymphoma.
Park
Byeong-Bae
BB
Division of Hematology/Oncology, Department of Internal Medicine, Hanyang University College of Medicine, 17 Haengdang-dong, Sungdong-gu, Seoul 133-791, Korea.
Kim
Jong Gwang
JG
Sohn
Sang Kyun
SK
Kang
Hye Jin
HJ
Lee
Seung Sook
SS
Eom
Hyeon Seok
HS
Kwon
Hyuck Chan
HC
Oh
Sung Yong
SY
Kang
Jung Hun
JH
Oh
Suk Joong
SJ
Shin
Ho-Jin
HJ
Suh
Cheolwon
C
Kim
Jung Han
JH
Kim
Ho Young
HY
Kim
Kihyun
K
Ryoo
Baek Yeol
BY
Kim
Won Seog
WS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016543:Central Nervous System Neoplasms / Q000556:secondary; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D018450:Disease Progression; D018572:Disease-Free Survival; D006801:Humans; D008207:Lymphatic Metastasis; D008223:Lymphoma / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009919:Orchiectomy; D011379:Prognosis; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery / Q000628:therapy*; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome