Introduction: Primary central nervous system lymphoma (PCNSL) is demarcated as lymphoma limited to the cranial-spinal axis lacking systemic disease. A growing incidence of this illness has been appreciated among patients with developed immunodeficiency syndrome (AIDS). Radiation theraphy is not suggested in combination with methotrexate since of an amplified risk of leukoencephalopathy and dementia. Therefore, optimization of actual treatments in CNS Lymphoma is essential.The objective of this study is to establish the efficacy of gamma knife radiosurgery combined with methotrexate in the treatment of PCNSL in HIV.
Methods: Retrospective, single-center, study in patients undergoing primary CNS Lymphoma treatment with radiosurgery using gamma knife perfection and intratecal methotrexate. Period of January 1998- January 2012. Preoperative analysis includes age, gender, body mass index (BMI), smoking history, HIV CD 4 levels and retroviral therapy was evaluated.
Results: Statistical analysis included 38 patients. 29 patients were diagnosed with AIDS. No significant differences were found in gender, BMI, age, or preoperative labs level when comparing control and treatment retroviral therapy. For radiosurgery analysis, there was no significant difference between patients in radiosurgery dosage 33 Gy (p 0.689). Number of brain lesions 3 (41%), 4 (39%), 7(14%) mayor of 8 (5%). The endpoints for the study were evaluated and the mean of survival rate for a standardized group 46.3 months. More probability of CNS lymphoma was find in individuals with a range of CD4 less of 200. Survival rate were (31.7) months. No statistically significant differences were detected between the patients in terms of postoperative methotrexate dosage received. Although not statistically significant, there was a trend showing decreases in quality of live in patients with a history of non-antiviral therapy before diagnosis.
Conclusions: Significant improvement in terms of survival rate and quality of life in patient treated with gamma knife radiosurgery and methotrexate.
Patient Care: Outcomes in Primary CNS lymphoma
Learning Objectives: Current therapy and coadjutors in Primary CNS lYMPHOMA