title: Primary CNS lymphoma treated with radiotherapy in Japan: a survey of patients treated in 2005-2009 and a comparison with those treated in 1985-2004.
abstract: BACKGROUND
  The aim of our study was to analyze changes over time in the characteristics, treatment, and outcome of patients with primary central nervous system lymphoma (PCNSL).
  
  
  METHODS
  Data on 315 patients with histologically proven PCNSL undergoing radiotherapy between 2005 and 2009 were collected from 20 Japanese institutions using a questionnaire. These data were then compared with data on 273 patients treated during the period 1995-2004 and those on 466 patients treated during the period 1985-1994.
  
  
  RESULTS
  In terms of patient and tumor characteristics, we found a significant increase in mean patient age in the 2005-2009 period compared to the 1985-2004 period (63 vs. 58-59 years, respectively) and in the percentage of patients with better performance status (PS) during the 2005-2009 period compared with the 1995-2004 period (World Health Organization PS 0-2: 73 vs. 65 %, respectively). Regarding treatment, relative to the 1995-2004 period, significant changes in the 2005-2009 period were (1) decreased rate of attempting tumor resection (23 vs. 44 %); (2) increased use of chemotherapy (78 vs. 68 %), and (3) increased use of methotrexate (MTX)-containing regimens (84 vs. 53 %). The 5-year overall survival rates were 15.3, 30.1, and 36.5 % for patients seen during the 1985-1994, 1995-2004, and 2005-2009 periods, respectively, but relapse-free survival did not improve between the 1995-2004 and 2005-2009 periods (26.7 vs. 25.7 % at 5 years, respectively). Patients receiving MTX-containing chemotherapy had 5-year survival rates of 19, 50, and 44 % during these three periods, respectively.
  
  
  CONCLUSIONS
  Although patient backgrounds differed among the study periods, recent trends were a high patient age, better PS, avoidance of extensive tumor resection, more frequent use of chemotherapy, and improved survival. The recent improvement in survival may be due to improvements in second-line treatment and supportive care.
authors.affiliation: Department of Radiology, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Nagoya, Aichi, 467-8601, Japan, yshiba@med.nagoya-cu.ac.jp.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Shibamoto
authors.forename: Minako
authors.initials: M
authors.lastname: Sumi
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Onodera
authors.forename: Haruo
authors.initials: H
authors.lastname: Matsushita
authors.forename: Chikao
authors.initials: C
authors.lastname: Sugie
authors.forename: Yukihisa
authors.initials: Y
authors.lastname: Tamaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Onishi
authors.forename: Eisuke
authors.initials: E
authors.lastname: Abe
authors.forename: Masahiko
authors.initials: M
authors.lastname: Koizumi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Miyawaki
authors.forename: Seiji
authors.initials: S
authors.lastname: Kubota
authors.forename: Etsuyo
authors.initials: E
authors.lastname: Ogo
authors.forename: Takuma
authors.initials: T
authors.lastname: Nomiya
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Takemoto
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Harada
authors.forename: Ippei
authors.initials: I
authors.lastname: Takahashi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ohmori
authors.forename: Naoya
authors.initials: N
authors.lastname: Ishibashi
authors.forename: Sunao
authors.initials: S
authors.lastname: Tokumaru
authors.forename: Kazunori
authors.initials: K
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D000368:Aged; D002490:Central Nervous System / Q000473:pathology* / Q000528:radiation effects; D016543:Central Nervous System Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007564:Japan; D008223:Lymphoma / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology*; D011795:Surveys and Questionnaires; D015996:Survival Rate
chemical_list: D008727:Methotrexate