Combined treatment of primary vitreoretinal lymphomas significantly prolongs the time to first relapse
Language English Country England, Great Britain Media print-electronic
Document type Comparative Study, Journal Article
PubMed
29378728
DOI
10.1136/bjophthalmol-2017-311574
PII: bjophthalmol-2017-311574
Knihovny.cz E-resources
- Keywords
- neoplasia, treatment medical,
- MeSH
- Time Factors MeSH
- Intravitreal Injections MeSH
- Middle Aged MeSH
- Humans MeSH
- Neoplasm Recurrence, Local physiopathology MeSH
- Methotrexate administration & dosage MeSH
- Survival Rate MeSH
- Eye Neoplasms drug therapy mortality physiopathology MeSH
- Retinal Neoplasms drug therapy mortality physiopathology MeSH
- Intraocular Lymphoma drug therapy mortality physiopathology MeSH
- Disease-Free Survival MeSH
- Prognosis MeSH
- Procarbazine administration & dosage MeSH
- Antineoplastic Combined Chemotherapy Protocols therapeutic use MeSH
- Flow Cytometry MeSH
- Retrospective Studies MeSH
- Rituximab administration & dosage MeSH
- Aged MeSH
- Vitreous Body drug effects pathology MeSH
- Vincristine administration & dosage MeSH
- Visual Acuity physiology MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Comparative Study MeSH
- Names of Substances
- Methotrexate MeSH
- Procarbazine MeSH
- Rituximab MeSH
- Vincristine MeSH
BACKGROUND: Vitreoretinal lymphomas belong to the family of central nervous system (CNS) lymphomas. The optimal approach for the treatment of isolated primary vitreoretinal lymphoma is unclear because of the lack of large comparative clinical series. Combination of intravitreal and systemic chemotherapy is recommended in many reports. The aim of our retrospective study was to compare the survival rate and prognosis of patients with vitreoretinal lymphoma with and without CNS involvement. METHODS: Twenty patients with vitreoretinal lymphomas were observed between the years 2004and2016, 10 patients with primary vitreoretinal lymphoma and 10 with primary CNS lymphoma. To compare survival rates, we included 53 patients diagnosed with primary CNS lymphoma without vitreoretinal involvement between the years 2002and2011 from our haemato-oncology department. RESULTS: The 5-year survival rate was estimated 71% in patients with vitreoretinal lymphoma in our observation. Significantly longer 5-year overall survival (P˂0.01) was observed in patients with vitreoretinal lymphoma compared with patients with primary CNS lymphoma without vitreoretinal involvement. Progression-free survival was almost equal in both groups of patients with primary vitreoretinal lymphoma and primary CNS lymphoma (P=0.363). The relapse of lymphoma was frequent (50%-60%) with the median time to first relapse of 31 months. Combined treatment (local and systemic) in patients without CNS involvement significantly prolonged progression-free survival in our study (P˂0.05). CONCLUSION: Combined treatment of primary vitreoretinal lymphoma significantly delays the relapse of lymphoma compared with local therapy alone. Intraocular involvement brings significant positive prognostic value when overall survival is compared.
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