Is deep brain involvement in intracranial primary central nervous system lymphoma of importance for penetration of chemotherapeutic agents?
Purpose: The purposes of this study are to study the impact of deep brain involvement on overall survival (OS) and progression-free survival (PFS) in intracranial primary CNS lymphoma (PCNSL), and to explore possible mechanisms for this impact using advanced MRI techniques.Methods: Seventy-nine pati...
| Publicado en: | Neuroradiology Vol. 60; no. 7; pp. 703 - 714 |
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| Autores principales: | , , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Springer Nature
Jul2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=130103761&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 130103761 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00283940 NYZ jtl: Neuroradiology issn: 00283940 maglogo: N pubinfo: dt: Jul2018 vid: 60 iid: 7 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 130103761 130103761 130103761 10.1007/s00234-018-2038-9 130103761 ppf: 703 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Is deep brain involvement in intracranial primary central nervous system lymphoma of importance for penetration of chemotherapeutic agents? aug: au: Meling, Torstein R. Latysheva, Anna Da Broi, Michele Jahr, Guro Holte, Harald Beiske, Klaus Emblem, Kyrre Eeg affil: Department of Neurosurgery, Oslo University Hospital, 0027, Oslo, Norway sug: subj: Brain Neoplasms Prognosis Lymphoma Prognosis Brain Neoplasms Diagnosis Magnetic Resonance Imaging Methods Brain Neoplasms Drug Therapy Lymphoma Drug Therapy Chemotherapy, Cancer Methods Human Academic Medical Centers Norway Norway Contrast Media Diagnostic Use Odds Ratio Karnofsky Performance Status Perfusion Imaging Hemodynamics Multivariate Analysis Age Factors Brain Blood Supply Image Enhancement Methods Brain Neoplasms Pathology Lymphoma Pathology Nervous System Physiology Antineoplastic Agents Administration and Dosage ab: Purpose: The purposes of this study are to study the impact of deep brain involvement on overall survival (OS) and progression-free survival (PFS) in intracranial primary CNS lymphoma (PCNSL), and to explore possible mechanisms for this impact using advanced MRI techniques.Methods: Seventy-nine patients with histologically verified PCNSL were identified from a prospective clinical database of patients treated at Oslo University Hospital between 2003 and 2014. Patients were treated per standard chemotherapeutic regimens (N = 57) or no chemotherapy (N = 22). Anatomical MRIs were available in all patients to assess tumor load and location based on contrast agent enhancement visible on T1-weighted images. Diffusion MRIs were available in 33 (42%) patients and perfusion MRI in 13 (16%) patients that received active treatment.Results: Across all patients, OS and PFS were 16.4 and 9.8 months, respectively. In multivariate analysis, MRI-based deep brain involvement (80%) was the only negative significant factor of OS (OR = 14.2; P < 0.005). While a reduced Karnofsky performance status was associated with deep brain involvement (P < 0.05), neither chemotherapy regimen, neurologic status, nor patient age were independent significant factors for OS or PFS in this setting. Compared to other tumors and healthy tissue levels, MRI perfusion showed more pathologic hemodynamic flow signatures in tumors with deep brain involvement.Conclusion: In intracranial PCNSL, the only significant prognostic factor for OS and PFS in multivariate analysis was age and deep brain involvement. While contingent on a small study sample, we hypothesize this may in part be explained by regional differences in vascular supply and delivery from a dysfunctional perfusion signature. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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