Primary XXXX . Results of treatment of 11 cases and review of the literature.

@entity1 @entity149 @entity5 @entity706
Eleven @entity1 with primary @entity149 (CNS) were treated at the Medical College of Wisconsin Affiliated Hospitals between 1964 and 1984. Three @entity1 had a prior history of immunosuppressive therapy following renal transplantation. All @entity1 had biopsy-proven disease and 10 of the 11 were treated with external radiation therapy. The doses to the @entity5 ranged from 34 to 59.4 Gray (Gy). Actuarial (life-table) survival rate was 82% at 1 year and 43% at 3 years. No recurrence was seen after 13 months. Eighty-six reports totaling 693 cases of primary @entity706 of the CNS were found in the literature. Of these, 308 cases were treated with a combination of surgery and irradiation. Overall survival at 5 years for those @entity1 who received more than 50 Gy compared with less than 50 Gy to the @entity5 was 42.3% versus 12.8% (p less than 0.05). Twenty-one @entity1 survived longer than 5 years. Late relapse was notable, with 10 (47.6%) of 21 @entity5 recurring between 5 and 12.5 years after diagnosis. Based on this review, a minimum of 50 Gy radiation to the @entity5 is recommended. While no statement regarding the efficacy of craniospinal irradiation or chemotherapy can be made in view of the small numbers, the use of craniospinal irradiation and/or systemic chemotherapy should be considered for future trials.
