% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@ARTICLE{Heider:301916,
      author       = {S. Heider and L. Allwohn and A. Rühle$^*$ and F. Ehret$^*$
                      and D. Kaul$^*$ and M. Oertel and N. B. Pepper and E.
                      Hoffmann and R. Bodensohn and A. Ruder and I. Popp and R.
                      Merten and H. T. Eich and D. Bernhardt and F. Schneller and
                      E. Schorb and N. Wielenberg$^*$ and S. E. Combs and A. L.
                      Grosu and N. H. Nicolay and C. Seidel},
      title        = {{C}omparison of survival and progression after focal- or
                      whole brain radiotherapy in patients with primary {CNS}
                      lymphoma - {R}esults from a large multicenter analysis of
                      the {G}erman {S}ociety of {R}adiation {O}ncology's
                      {N}euro-{R}adio-{O}ncology {W}orking {G}roup ({DEGRO}
                      {AG}-{NRO}).},
      journal      = {Radiotherapy and oncology},
      volume       = {209},
      issn         = {0167-8140},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier Science},
      reportid     = {DKFZ-2025-01186},
      pages        = {110984},
      year         = {2025},
      note         = {Volume 209, August 2025, 110984},
      abstract     = {Primary central nervous system lymphoma (PCNSL) is a rare
                      but aggressive disease. The application of radiotherapy (RT)
                      as part of treatment usually involved whole-brain
                      radiotherapy (WBRT). Focal radiotherapy (fRT) might be
                      locally active, but comparative outcome data is lacking.Data
                      from a multicenter registry of the German Society of
                      Radiation Oncology's Neuro-Radio-Oncology Working Group
                      (DEGRO AG-NRO) was analyzed. Patients treated for PCNSL
                      between 2007 and 2023 who received RT at any stage of their
                      disease were included. Kaplan-Meier and Cox proportional
                      hazards regression analyses were conducted to compare
                      survival between focal (fRT) and whole-brain radiotherapy
                      (WBRT).Survival data of 151 patients from eight centers were
                      available. The median age at diagnosis was 66.5 years, and
                      the median Eastern Cooperative Oncology Group Performance
                      Status Scale (ECOG PS) was 2. Eighteen percent of patients
                      (n = 27) received primary RT, 33 $\%$ (n = 49) consolidation
                      RT, and 49 $\%$ (n = 73) RT for recurrent disease. Median
                      overall survival (OS) from diagnosis was 24.1 months (95
                      $\%$ CI: 14.7-33.4), and median survival after RT was 7.2
                      months (95 $\%$ CI: 4.5-10.0). In patients treated with fRT
                      (n = 28) median OS was 67.6 months (95 $\%$ CI: 35.7-99.6)
                      compared to 20.1 months after WBRT (n = 123, 95 $\%$ CI:
                      10.5-29.8) (HR = 0.5, p = 0.016). Median survival after RT
                      was also longer with fRT (44.0 months, 95 $\%$ CI: 5.9-82.1)
                      than with WBRT (5.8 months, 95 $\%$ CI: 3.2-8.4) (HR = 0.5,
                      p = 0.017). In recurrent disease median PFS after use of fRT
                      was 3.8 months, compared to 3.0 months after WBRT (p =
                      0.164). After fRT, in 16/28 (39 $\%)$ patients tumor
                      progression was observed (2/16 in-field, 3/16 out-field,
                      3/16 mixed, 8/16 unknown). In multivariate Cox-regression
                      analysis, histology other than diffuse large B-cell lymphoma
                      (HR = 0.345, p < 0.01) and fRT (HR = 0.518, p < 0.05)
                      remained independently associated with improved OS.fRT may
                      be a beneficial treatment option for patients with PCNSL and
                      needs to be studied further in prospective clinical trials.},
      keywords     = {Focal radiotherapy (Other) / PCNSL (Other) / Primary CNS
                      lymphoma (Other) / Stereotactic radiotherapy (Other) / Whole
                      brain irradiation (Other)},
      cin          = {FR01 / BE01},
      ddc          = {610},
      cid          = {I:(DE-He78)FR01-20160331 / I:(DE-He78)BE01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40490053},
      doi          = {10.1016/j.radonc.2025.110984},
      url          = {https://inrepo02.dkfz.de/record/301916},
}