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Article Dans Une Revue Clinical Cancer Research Année : 2011

Primary CNS lymphoma in children and adolescents: a descriptive analysis from the International Primary CNS Lymphoma Collaborative Group (IPCG).

Sheila Weitzman
  • Fonction : Auteur
Lauren E Abrey
  • Fonction : Auteur
Edward Neuwelt
  • Fonction : Auteur
Nancy D Doolittle
  • Fonction : Auteur
Joachim Baehring
  • Fonction : Auteur
Kamnesh Pradhan
  • Fonction : Auteur
S Eric Martin
  • Fonction : Auteur
Michael Guerrera
  • Fonction : Auteur
Shafqat Shah
  • Fonction : Auteur
Michael Silver
  • Fonction : Auteur
Rebecca A Betensky
  • Fonction : Auteur
Tracy Batchelor
  • Fonction : Auteur

Résumé

PURPOSE: To describe the demographic and clinical features and outcomes for children and adolescents with primary CNS lymphoma (PCNSL). EXPERIMENTAL DESIGN: A retrospective series of children and adolescents with PCNSL was assembled from 10 cancer centers in 3 countries. RESULTS: Twenty-nine patients with a median age of 14 years were identified. Sixteen (55%) had Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 1 or greater. Frontline therapy consisted of chemotherapy only in 20 patients (69%), while 9 (31%) had chemotherapy plus cranial radiotherapy. Most patients received methotrexate (MTX)-based regimens. Overall response rate was 86% (complete remission 69%, partial remission 17%). The 2-year progression-free survival (PFS) and overall survival (OS) rates were 61% and 86%, respectively; the 3-year OS was 82%. Univariate analyses were conducted for age (≤ 14 vs. >14 years), PS (0 or 1 vs. >1), deep brain lesions, MTX dose, primary treatment with chemotherapy alone, intrathecal chemotherapy, and high-dose therapy. Primary treatment with chemotherapy alone was associated with better overall response rates with an odds ratio (OR) of 0.125 (P = 0.02). There was a marginally significant relationship between higher doses of MTX and response (OR = 1.5, P = 0.06). ECOG-PS of 0 to 1 was the only factor associated with better outcome with hazard ratios of 0.136 (P = 0.017) and 0.073 (P = 0.033) for PFS and OS, respectively. CONCLUSION: This is the largest series collected of pediatric PCNSL. The outcome of children and adolescents seems to be better than in adults. PS of 0 to 1 is associated with better survival.

Domaines

Cancer

Dates et versions

hal-00770760 , version 1 (07-01-2013)

Identifiants

Citer

Oussama Abla, Sheila Weitzman, Jean-Yves Blay, Brian Patrick O'Neill, Lauren E Abrey, et al.. Primary CNS lymphoma in children and adolescents: a descriptive analysis from the International Primary CNS Lymphoma Collaborative Group (IPCG).. Clinical Cancer Research, 2011, 17 (2), pp.346-52. ⟨10.1158/1078-0432.CCR-10-1161⟩. ⟨hal-00770760⟩
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