Feasibility and Efficacy of Individualized Radiation Therapy for Primary Central Nervous System Lymphoma: Radiation Treatment Planning According to Treatment Response by Radiographic Assessment.

• Material Type: 博士論文
• Title: Feasibility and Efficacy of Individualized Radiation Therapy for Primary Central Nervous System Lymphoma: Radiation Treatment Planning According to Treatment Response by Radiographic Assessment.
• Author/Editor: Morimoto, Yoko; Inoue, Kazuya; Matsuda, Ryosuke; Miyasaka, Toshiteru; Wakai, Nobuhide; Yamaki, Kaori; Miura, Sachiko; Asakawa, Isao; Tamamoto, Tetsuro; Hasegawa, Masatoshi
• Author Heading: Morimoto, Yoko; Inoue, Kazuya; Matsuda, Ryosuke; Miyasaka, Toshiteru; Wakai, Nobuhide; Yamaki, Kaori; Miura, Sachiko; Asakawa, Isao; Tamamoto, Tetsuro; Hasegawa, Masatoshi
• Publication, Distribution, etc.: 奈良医学会
• Publication Date: 2019-06-19
• Publication Date (W3CDTF): 2019-06-19
• Alternative Title: 中枢神経系原発悪性リンパ腫の放射線治療個別化の妥当性と有用性：画像評価を用いた治療効果に基づく放射線治療計画
• Periodical title: Journal of Nara Medical Association
• No. or year of volume/issue: 70 (in press) 1,2,3 (in press)
• Volume: 70 (in press)
• Issue: 1,2,3 (in press)
• ISSN (Periodical Title): ISSN : 1345-0069
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2019-03-15
• Dissertation Number: 甲第705号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Primary central nervous system lymphoma; Radiation therapy; Treatment response evaluation; Whole brain radiation dose; Boost irradiation
• Target Audience: 一般
• Note (General): type:Thesis; Background: To assess the feasibility and efficacy of individualized treatment selection in radiation therapy (RT) for primary central nervous system lymphoma (PCNSL) according to treatment response by radiographic assessment. Methods: The details of recurrence and change in performance status (PS) were assessed in 31 patients with histologically confirmed PCNSL treated between 2000 and 2016. During the treatment period, radiographic assessment was conducted, and RT planning (RTP) was determined individually by treatment response. Results: At a median follow-up of 28.2 months, 9 patients were alive and 7 of whom were relapse-free. Two-year overall survival (OS) and progression-free survival (PFS) rates were 69.3% and 52.7%, with median survival times (MSTs) of 36.5 months and 24.4 months, respectively. Two-year local recurrence rate was 40.5% and the median time to local recurrence from treatment initiation was 27.9 months. All patients were scheduled to receive whole-brain RT (WBRT) and subsequent partial-brain RT(PBRT), with a median total dose to the tumor bed of 46 Gy and median WBRT dose of 30 Gy. Eight patients received reduced-dose WBRT (rd-WBRT) (<30 GY), and 13 patients who could not achive a complete response (CR) during the RT period received additional boost radiation after WBRT and PBRT, with a median dose of 6 Gy. Over 70% of local recurrence occurred within areas in which only WBRT was conducted (median dose of 30.3 Gy). Two-year occurrence rate of neurotoxicity over grade 2 was 49.5%. PS at 24 months after RT was maintained in 12 patIents. Conclusions: lndividual RTP using radiographic assessment led to reasonable survival and disease control rates with mild treatment-related toxicity. For patients not receiving chemotherapy or lacking a CR after chemotherapy and WBRT, WBRT followed by PBRT and additional boost radiation for poor RT responders might be effective. However, even for patients with CR after chemotherapy, a WBRT dose of 30 Gy or higher might be necessary for local control.; 博士（医学）・甲第705号・平成31年3月15日; identifier:Journal of Nara Medical Association Vol.70 No.1,2,3 p.1-19 (2019.06); identifier:13450069; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3553; identifier:Journal of Nara Medical Association, 70 (in press)(1,2,3 (in press))
• Access Restrictions: インターネット公開
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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