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@ARTICLE{Bigge:302841,
      author       = {J. C. Bigge and S. Bendrich and H. Treiber and E. Aydilek
                      and N. Brökers and G. G. Wulf and C. M. Zwerenz and M. Z.
                      Anczykowski and S. Donath and R. A. El Shafie and L.-A. von
                      Diest and J. T. Oelmann and M. A. Schirmer and L. H. Dröge
                      and M. Leu and B. Chapuy$^*$ and S. Rieken and M. Guhlich},
      title        = {{C}linical {P}redictors and {R}ecurrence {C}haracteristics
                      {F}ollowing {R}adiotherapy for {P}rimary {C}entral {N}ervous
                      {S}ystem {L}ymphoma: {A} {R}etrospective {C}ohort {S}tudy.},
      journal      = {Cancers},
      volume       = {17},
      number       = {13},
      issn         = {2072-6694},
      address      = {Basel},
      publisher    = {MDPI},
      reportid     = {DKFZ-2025-01381},
      pages        = {2176},
      year         = {2025},
      abstract     = {Background/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.},
      keywords     = {PCNSL (Other) / overall survival (Other) / primary central
                      nervous system lymphoma (Other) / prognostic factors (Other)
                      / radiotherapy (Other) / real-world-analysis (Other) /
                      seizures (Other)},
      cin          = {BE01},
      ddc          = {610},
      cid          = {I:(DE-He78)BE01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40647475},
      pmc          = {pmc:PMC12248931},
      doi          = {10.3390/cancers17132176},
      url          = {https://inrepo02.dkfz.de/record/302841},
}