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000302841 1001_ $$aBigge, Jan Carl$$b0
000302841 245__ $$aClinical Predictors and Recurrence Characteristics Following Radiotherapy for Primary Central Nervous System Lymphoma: A Retrospective Cohort Study.
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000302841 520__ $$aBackground/Objectives: Primary central nervous system lymphoma (PCNSL) is a rare but aggressive tumor, primarily affecting elderly patients. Radiotherapy (RT) remains an important treatment option, particularly for patients who are ineligible for systemic chemotherapy. This study aims to identify prognostic factors and evaluate recurrence patterns in a real-world cohort of PCNSL patients treated with RT. Methods: We retrospectively analyzed 64 PCNSL patients treated with radiotherapy at our institution between 2000 and 2022. Clinical characteristics, treatment details, and outcomes were collected by chart review. Overall survival (OS) was analyzed using Kaplan-Meier and Cox regression methods. Recurrence patterns were assessed based on available post-treatment imaging. Results: Median patient age was 71 years (range: 31-83); 53.1% had an Eastern Cooperative Oncology Group (ECOG) performance status ≥2. Radiotherapy was used as first-line treatment in 62.5% of cases, primarily due to contraindications to chemotherapy. Median OS was 10 months from diagnosis. Age, poor performance status, seizures at presentation, absence of systemic therapy, incomplete radiotherapy, and <80% applied dose of planned radiotherapy were associated with inferior OS in our univariable analysis. Multivariable analysis confirmed age, systemic therapy, seizures, and radiotherapy dose <80% as independent predictors. Among twenty-nine patients with imaging follow-up, eight recurrences after RT were documented: six of those within, and two outside of the initially affected areas. All recurrences occurred within previously irradiated areas. Conclusions: This study confirms known negative prognostic factors in PCNSL and underscores the importance of systemic chemotherapy for curatively intended treatments aiming for prolonged survival. The recurrence patterns observed question the added benefit of whole-brain irradiation in preventing distant relapses. These findings support the need for prospective trials to optimize radiotherapy strategies while balancing efficacy and neurotoxicity.
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000302841 650_7 $$2Other$$aPCNSL
000302841 650_7 $$2Other$$aoverall survival
000302841 650_7 $$2Other$$aprimary central nervous system lymphoma
000302841 650_7 $$2Other$$aprognostic factors
000302841 650_7 $$2Other$$aradiotherapy
000302841 650_7 $$2Other$$areal-world-analysis
000302841 650_7 $$2Other$$aseizures
000302841 7001_ $$aBendrich, Stephanie$$b1
000302841 7001_ $$00000-0003-4436-5493$$aTreiber, Hannes$$b2
000302841 7001_ $$00000-0003-1418-2725$$aAydilek, Enver$$b3
000302841 7001_ $$aBrökers, Nils$$b4
000302841 7001_ $$00000-0002-7669-3785$$aWulf, Gerald Georg$$b5
000302841 7001_ $$aZwerenz, Carla Marie$$b6
000302841 7001_ $$aAnczykowski, Mahalia Zoe$$b7
000302841 7001_ $$aDonath, Sandra$$b8
000302841 7001_ $$aEl Shafie, Rami A$$b9
000302841 7001_ $$avon Diest, Lisa-Antonia$$b10
000302841 7001_ $$aOelmann, Jan Tobias$$b11
000302841 7001_ $$00000-0003-1375-4496$$aSchirmer, Markus Anton$$b12
000302841 7001_ $$00000-0002-5378-4246$$aDröge, Leif Hendrik$$b13
000302841 7001_ $$00000-0002-3883-6837$$aLeu, Martin$$b14
000302841 7001_ $$00000-0002-6485-8773$$aChapuy, Björn$$b15
000302841 7001_ $$00009-0000-7018-2856$$aRieken, Stefan$$b16
000302841 7001_ $$00000-0002-2599-6196$$aGuhlich, Manuel$$b17
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