PB1792 AGE AS AN INDEPENDENT PREDICTIVE FACTOR IN SURVIVAL OUTCOMES OF MULTIMODALITY TREATMENTS FOR PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA: A REVIEW FROM TERTIARY INSTITUTION
Notice bibliographique
Résumé
Background: Primary central nervous system lymphoma (PCNSL) is a rare malignancy with a median survival of less than 3 months, if untreated. Multimodality treatments with high‐dose methotrexate (HD‐MTX)‐based systemic therapy and/or whole brain irradiation for consolidation or salvage constitutes the most commonly used treatment approach. Due to severe treatment toxicity and aggressive course of the disease, not all patients benefit from this treatment approach. Aims: In this retrospective study, we aimed to identify various clinical parameters that predicted outcomes on survival, and response to various treatments in patients with PCNSL. Methods: Patients diagnosed with PCNSL between 2002 and 2017 were selected for analysis. Data on patient demographics, tumor characteristics and treatment were collected and analyzed for correlation with clinical outcomes. Survival curves were generated with the Kaplan‐Meier method and compared using log‐rank test. Multivariate analysis was performed where prognostic variables and patient outcome were correlated with Cox proportional hazard model. Results: A total of 82 patients were identified and selected for analysis. Median age at diagnosis was 68 years (range 30‐89 years) and median follow up was 3.7 years. The majority (86.6%) of tumors were identified as diffuse large B‐cell lymphoma on histology. Among the 82 patients, 10 (12.2%), 31 (37.8%) and 23 (28.0%) patients received systemic therapy (CT) only, radiotherapy (RT) only and systemic therapy followed by salvage radiotherapy (CRT), respectively, while 18 (22.0%) patients received supportive care (SC) only. Median time interval between diagnosis and treatment was 33 days for CT group and 63 days for RT group. Median overall survival (OS) of the entire cohort was 11.1 months (95% CI 6.1‐15.5 months), while median OS for RT, CRT and SC groups were 8.8 months (95% CI 4.5‐11.3 months), 30.1 months (95% CI 19.3‐41.0 months) and 3.3 months (95% CI 0.8‐5.8 months), respectively (median OS for CT group not reached). Multivariate analysis demonstrated that both the use of systemic therapy (hazard ratio [HR] 0.23, 95% CI 0.11‐0.49, p < 0.001) and radiotherapy (HR 0.54, 95% CI 0.32‐0.92, p = 0.022) were associated with improved survival in the total population, while age (p = 0.48) or type of tumor (p = 0.88) did not demonstrate any statistical significance. Subgroup analysis showed that systemic therapy in patients younger than 70 years of age was associated with improved OS (HR 0.13, 95% CI 0.05‐0.32, p < 0.001), whereas in elderly patient population (70 years of age or older), addition of radiotherapy was associated with improved OS (HR 0.45, 95% CI 0.21‐0.96, p = 0.039). Summary/Conclusion: Our results concur with the published literature demonstrating the survival benefit with the use of systemic therapy in younger patient population. Radiotherapy was independently associated with an improved overall survival in older patient population and therefore should be considered as palliative treatment of choice in the elderly population who may not be candidates for systemic therapy. Further prospective studies are required to validate our findings as well as optimization of radiotherapy in this population.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,005 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».