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Patterns of treatment in older adults with primary central nervous system lymphoma†
Article first published online: 23 JUL 2007
Copyright © 2007 American Cancer Society
Volume 110, Issue 6, pages 1338–1344, 15 September 2007
How to Cite
Panageas, K. S., Elkin, E. B., Ben-Porat, L., DeAngelis, L. M. and Abrey, L. E. (2007), Patterns of treatment in older adults with primary central nervous system lymphoma. Cancer, 110: 1338–1344. doi: 10.1002/cncr.22907
A correction was made to Table 2 of this article post-online publication in order to protect patient identity and comply with the SEER-Medicare data use agreement. These changes do not change the core data or the conclusions of the article in any way. The authors apologize for this oversight and any confusion that may have ensued.
- Issue published online: 31 AUG 2007
- Article first published online: 23 JUL 2007
- Manuscript Accepted: 15 MAY 2007
- Manuscript Revised: 3 MAY 2007
- Manuscript Received: 20 MAR 2007
- Memorial Sloan-Kettering Cancer Center Cancer and Aging Program
- Byrne Fund
- primary central nervous system lymphoma;
The incidence of primary central nervous system lymphoma (PCNSL) has increased in recent decades and is highest in people aged ≥65 years. Radiotherapy (XRT) and systemic chemotherapy (CTX), alone or in combination, are reported to extend survival, but treatment-related toxicity is a particular concern in the elderly. The objective of the current study was to identify factors associated with the receipt and type of treatment in a population-based cohort of older PCNSL patients.
Using Surveillance, Epidemiology, and End Results (SEER) cancer registry data linked with Medicare claims, the authors identified PCNSL cases in adults aged ≥65 years who were diagnosed between 1994 and 2002. Initial treatment was defined as XRT alone, CTX alone, combined CTX and XRT, or no treatment, based on Medicare claims in the 6 months after diagnosis. The authors assessed the effects of age, comorbidity, and sociodemographic characteristics on the odds of receiving treatment.
Of 579 PCNSL patients, 464 (80%) received any treatment. XRT alone was the most common modality (46%), followed by combined therapy (33%) and CTX alone (22%). The type of treatment varied by age (P < .0001). The use of CTX alone or in combination with XRT decreased with increasing age, whereas the use of XRT alone increased with age. In adjusted analysis, younger age (P < .01) was found to be predictive of the receipt of any treatment. The use of CTX decreased with age (P < .0001). The median survival was 7 months (95% confidence interval, 6–8 months); no significant time trends were observed.
Although the majority of older PCNSL patients received treatment, most did not receive optimal therapy. Age was found to have the greatest influence on treatment selection. Overall survival in elderly PCNSL patients appears to be poor. Cancer 2007. © 2007 American Cancer Society.