       Document 0326
 DOCN  M9460326
 TI    Radiotherapy of primary central nervous system lymphoma in patients with
       and without human immunodeficiency virus. Ten years of treatment
       experience at the University of California San Francisco.
 DT    9408
 AU    Ling SM; Roach M 3rd; Larson DA; Wara WM; Department of Radiation
       Oncology, University of California San; Francisco, San Francisco 94143.
 SO    Cancer. 1994 May 15;73(10):2570-82. Unique Identifier : AIDSLINE
       MED/94228443
 AB    BACKGROUND. Classic human immunodeficiency virus (HIV) negative primary
       central nervous system lymphoma (PCNSL) is a relatively uncommon
       occurrence, whereas the incidence of HIV positive PCNSL has increased
       dramatically during the past 5 years. Between 2% and 6% of all patients
       with acquired immune deficiency syndrome (AIDS) will have PCNSL develop
       clinically, and as many as 11% will have PCNSL found at autopsy. In the
       United States, some of the earliest and most extensive experience with
       HIV positive PCNSL has occurred in San Francisco. This article reports
       on PCNSL in patients with and without HIV. METHODS. Using our
       diagnosis-based computer retrieval system, we identified all patients
       treated with radiotherapy for PCNSL between January 1982 and January
       1992 and reviewed their medical records. Population characteristics,
       risk factors and length of survival (LOS), were analyzed. Statistical
       methodology included the Cox proportional hazards model and Kaplan-Meier
       survival curves. RESULTS. Fifty-six patients were identified with PCNSL,
       of which 41 were HIV positive and 15 were HIV negative. There was a
       fourfold increase in the total number of PCNSL cases during the time
       period 1987-1991 as compared with the preceding 5 years; these cases
       primarily were in the HIV positive group. The average Karnofsky
       performance score (KPS) in the HIV positive group was 50, whereas in the
       HIV negative group, the KPS was 35. However, the median LOS in the HIV
       positive group was 3 months, whereas in the HIV negative group it was 20
       months. Within each group, there was a statistically significant
       correlation between KPS and LOS. CONCLUSIONS. Patients with HIV and
       PCNSL have a much shorter median LOS than do patients with PCNSL but
       without HIV; however, the outcome for both groups is dismal. Randomized
       clinical trials are needed to determine which patients with HIV might
       benefit from more aggressive therapy and to determine the optimal choice
       and dosages of chemoradiation therapy for patients with PCNSL without
       HIV.
 DE    Adolescence  Adult  Aged  Brain Neoplasms/MORTALITY/*RADIOTHERAPY
       Female  Human  Lymphoma/MORTALITY/*RADIOTHERAPY  Lymphoma,
       AIDS-Related/MORTALITY/*RADIOTHERAPY  Male  Middle Age  Proportional
       Hazards Models  Retrospective Studies  Risk Factors  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

