@entity149 from XXXX : treatment and prophylaxis.

@entity1 @entity6220 @entity706 @entity262 @entity149 @entity2592 @entity1893 @entity1499
Central nervous system (CNS) @entity706 was identified in 96 @entity1 treated for @entity1893 at Memorial Sloan-Kettering Cancer Center between 1975 and 1981. During the same period, 68 other @entity1 with @entity1893 but no @entity6220 received prophylactic CNS chemotherapy. In the 156 total @entity1 , the @entity706 were diffuse in 96 percent, and 67 percent were stage IV at diagnosis. CNS involvement was present at initial diagnosis in 27 percent, at relapse in 26 percent, and during the course of progressive @entity262 in 47 percent. CNS involvement was asymptomatic in 10 percent. Cytologic study of the cerebrospinal fluid was the most sensitive and specific laboratory test, but often (22 percent) more than one lumbar puncture was required to identify malignant cells. @entity149 was treated in 85 @entity1 , 46 by intracerebroventricular cannulae; 81 percent improved. Although median survival after the diagnosis of @entity6220 was four months, there were seven long-term disease-free survivors and the @entity6220 contributed to death in only 14 percent. In 52 percent of treated @entity1 , there was no @entity149 at autopsy. CNS prophylaxis was with @entity1499 or @entity2592 , usually by lumbar puncture; an intraventricular cannula was used in seven @entity1 . Although this group of high-risk @entity1 with @entity1893 had a high systemic response rate and the median projected survival was greater than five years, @entity149 developed in eight @entity1 (12 percent). In five, @entity149 occurred as an apparently isolated relapse site. The role of CNS chemoprophylaxis in high-risk @entity1 with @entity1893 is still uncertain.
