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Outcome and patterns of failure in testicular lymphoma: a multicenter Rare Cancer Network study.
- Source :
-
International Journal of Radiation Oncology, Biology, Physics . Mar2002, Vol. 52 Issue 3, p652-656. 5p. - Publication Year :
- 2002
-
Abstract
- <bold>Purpose: </bold>To assess the outcome and patterns of failure in patients with testicular lymphoma treated by chemotherapy (CT) and/or radiation therapy (RT).<bold>Methods and Materials: </bold>Data from a series of 36 adult patients with Ann Arbor Stage I (n = 21), II (n = 9), III (n = 3), or IV (n = 3) primary testicular lymphoma, consecutively treated between 1980 and 1999, were collected in a retrospective multicenter study by the Rare Cancer Network. Median age was 64 years (range: 21-91 years). Full staging workup (chest X-ray, testicular ultrasound, abdominal ultrasound, and/or thoracoabdominal computer tomography, bone marrow assessment, full blood count, lactate dehydrogenase, and cerebrospinal fluid evaluation) was completed in 18 (50%) patients. All but one patient underwent orchidectomy, and spermatic cord infiltration was found in 9 patients. Most patients (n = 29) had CT, consisting in most cases of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) with (n = 17) or without intrathecal CT. External RT was delivered to scrotum alone (n = 12) or testicular, iliac, and para-aortic regions (n = 8). The median RT dose was 31 Gy (range: 20-44 Gy) in a median of 17 fractions (10-24), using a median of 1.8 Gy (range: 1.5-2.5 Gy) per fraction. The median follow-up period was 42 months (range: 6-138 months).<bold>Results: </bold>After a median period of 11 months (range: 1-76 months), 14 patients presented lymphoma progression, mostly in the central nervous system (CNS) (n = 8). Among the 17 patients who received intrathecal CT, 4 had a CNS relapse (p = NS). No testicular, iliac, or para-aortic relapse was observed in patients receiving RT to these regions. The 5-year overall, lymphoma-specific, and disease-free survival was 47%, 66%, and 43%, respectively. In univariate analyses, statistically significant factors favorably influencing the outcome were early-stage and combined modality treatment. Neither RT technique nor total dose influenced the outcome. Multivariate analysis revealed that the most favorable independent factors predicting the outcome were younger age, early-stage disease, and combined modality treatment.<bold>Conclusions: </bold>In this multicenter retrospective study, CNS was found to be the principal site of relapse, and no extra-CNS lymphoma progression was observed in the irradiated volumes. More effective CNS prophylaxis, including combined modalities, should be prospectively explored in this uncommon site of extranodal lymphoma. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ANTINEOPLASTIC agents
*CASTRATION
*COMBINED modality therapy
*COMPARATIVE studies
*DOXORUBICIN
*LYMPHOMAS
*RESEARCH methodology
*MEDICAL cooperation
*PROGNOSIS
*RADIATION doses
*RESEARCH
*TESTIS tumors
*TUMOR classification
*VINCRISTINE
*DISEASE relapse
*EVALUATION research
*TREATMENT effectiveness
*RETROSPECTIVE studies
*CYCLOPHOSPHAMIDE
*PREDNISOLONE
Subjects
Details
- Language :
- English
- ISSN :
- 03603016
- Volume :
- 52
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- International Journal of Radiation Oncology, Biology, Physics
- Publication Type :
- Academic Journal
- Accession number :
- 137993430
- Full Text :
- https://doi.org/10.1016/s0360-3016(01)02647-5