title: Therapeutic and survival outcomes following treatment of primary central nervous system lymphoma: a 12-year case study.
abstract: OBJECTIVE
  The study primarily aimed to investigate therapeutic and survival outcomes following definitive treatment of primary central nervous system lymphoma (PCNSL).
  
  
  METHODS
  All patients with histopathologically proven PCNSL at our institute between 1998 and 2009 were recruited. The collated data included demographic, laboratory, neuroimaging, therapeutic and survival aspects.
  
  
  RESULTS
  Of 85 participants with the mean age of 52.8 years, 79 underwent neurosurgical procedures endeavoring for diagnosis or decompression. Fifty patients who received definitive treatment in our institute were evaluated for therapeutic response. In multivariate analysis, there was no variable associated with good response rate. Eastern Cooperative Oncology Group (ECOG) performance status >1 and elevated cerebrospinal fluid (CSF) protein level >45 mg/dL were significant prognostic factors of poor survival outcome as estimated by Cox regression analysis. The patients treated by high-dose methotrexate (HD-MTX)-based protocols with or without radiotherapy (RT) achieved significantly longer median survival than those treated by RT alone or other kinds of chemotherapy.
  
  
  CONCLUSIONS
  Neurosurgical procedure plays an important role for diagnosis of PCNSL. Surgical resection has no role in curative treatment and should be discarded unless considerable mass effect develops. HD-MTX should be considered as the primary chemotherapy for individuals agonizing from the disease.
authors.affiliation: Division of Neurosurgery, Department of Surgery Faculty of Medicine Siriraj Hospital Mahidol University, Bangkok, Thailand - bunpotsi@yahoo.com.
authors.forename: B
authors.initials: B
authors.lastname: Sitthinamsuwan
authors.forename: S
authors.initials: S
authors.lastname: Rujimethapass
authors.forename: Y
authors.initials: Y
authors.lastname: Chinthammitr
authors.forename: J
authors.initials: J
authors.lastname: Treetipsatit
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016543:Central Nervous System Neoplasms / Q000188:drug therapy* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D008727:Methotrexate