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Neuhauser, M; Roetzer, T; Oberndorfer, S; Kitzwoegerer, M; Payer, F; Unterluggauer, JJ; Haybaeck, J; Stockhammer, G; Iglseder, S; Moser, P; Thomé, C; Stultschnig, M; Wuertz, F; Brandner-Kokalj, T; Weis, S; Bandke, D; Pichler, J; Hutterer, M; Krenosz, KJ; Boehm, A; Mayrbaeurl, B; Hager-Seifert, A; Kaufmann, H; Dumser, M; Reiner-Concin, A; Hoenigschnabl, S; Kleindienst, W; Hoffermann, M; Dieckmann, K; Kiesel, B; Widhalm, G; Marosi, C; Jaeger, U; Hainfellner, A; Hackl, M; Hainfellner, JA; Preusser, M; Woehrer, A.
Increasing use of immunotherapy and prolonged survival among younger patients with primary CNS lymphoma: a population-based study.
Acta Oncol. 2019; 49(11):1-10
Doi: 10.1080/0284186X.2019.1599137
[OPEN ACCESS]
Web of Science
PubMed
FullText
FullText_MUG
- Co-authors Med Uni Graz
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Haybäck Johannes
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Payer Franz
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Unterluggauer Julia Judith
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- Abstract:
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Primary CNS lymphoma is a highly aggressive and rare type of extranodal non-Hodgkin lymphoma. Although, new therapeutic approaches have led to improved survival, the management of the disease poses a challenge, practice patterns vary across institutions and countries, and remain ill-defined for vulnerable patient subgroups.
Using information from the Austrian Brain Tumor Registry we followed a population-based cohort of 189 patients newly diagnosed from 2005 to 2010 through various lines of treatment until death or last follow-up (12-31-2016). Prognostic factors and treatment-related data were integrated in a comprehensive survival analysis including conditional survival estimates.
We find variable patterns of first-line treatment with increasing use of rituximab and high-dose methotrexate (HDMTX)-based poly-chemotherapy after 2007, paralleled by an increase in median overall survival restricted to patients aged below 70 years. In the entire cohort, 5-year overall survival was 24.4% while 5-year conditional survival increased with every year postdiagnosis.
In conclusion, we show that the use of poly-chemotherapy and immunotherapy has disseminated to community practice to a fair extent and survival has increased over time at least in younger patients. Annually increasing conditional survival rates provide clinicians with an adequate and encouraging prognostic measure.