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dc.contributor.authorSamhouri, Yazan
dc.contributor.authorMustafa Ali, Moaath K
dc.contributor.authorKhan, Cyrus
dc.contributor.authorWegner, Rodney
dc.contributor.authorLee, Seung Tae
dc.contributor.authorLister, John
dc.date.accessioned2022-04-11T15:58:56Z
dc.date.available2022-04-11T15:58:56Z
dc.date.issued2022-04-01
dc.identifier.urihttp://hdl.handle.net/10713/18535
dc.description.abstractBACKGROUND/AIM: The addition of radiation to chemotherapy in elderly patients with primary central nervous system lymphoma (PCNSL) remains controversial. This aim of this study was to assess the trend of combined modality treatment (CMT) and compare its survival with chemotherapy alone and radiation alone in non-HIV patients. PATIENTS AND METHODS: We identified 6,537 patients who received single treatment modality, CMT, or no treatment at all between 2004 and 2015 from the National Cancer Database. Factors affecting treatment selection were investigated using a logistic regression model. Annual percentage change (APC) was calculated to assess the trend of CMT use. A propensity score weighting methodology was used to compare survival outcomes. RESULTS: Only 12.8% of patients received CMT, and this proportion steadily declined between 2004 (17.7%) and 2015 (8.7%), with an APC of -6.0% (95%CI=-8.0 - -4.0, p-value <0.001) during the 12 years. Apart from classical prognostic factors (age and comorbidities), treatment selection was significantly influenced by sex, facility type, degree of urbanization, and type of insurance. CMT had improved survival [median overall survival 19.5 months (95%CI=15.7-22.8)] compared with single-modality treatment. This effect was more prominent in the first year. CONCLUSION: Socioeconomic factors affect the selection of treatment in elderly patients with PCNSL. CMT is falling out of favor in this patient population due to the risks of neurotoxicity. Further work should focus on developing strategies that minimize toxicity and access disparities without compromising survival.en_US
dc.description.urihttps://doi.org/10.21873/anticanres.15663en_US
dc.language.isoenen_US
dc.publisherInternational Institute of Anticancer Researchen_US
dc.relation.ispartofAnticancer Researchen_US
dc.rightsCopyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.en_US
dc.subjectCMTen_US
dc.subjectPCNSLen_US
dc.subjectchemotherapyen_US
dc.subjectelderlyen_US
dc.subjectradiationen_US
dc.titleThe Trend of Combined Modality Treatment and its Outcomes in Elderly Patients With Primary CNS Lymphoma: A 12-year Population-based Analysis Using Propensity Score.en_US
dc.typeArticleen_US
dc.identifier.doi10.21873/anticanres.15663
dc.identifier.pmid35347005
dc.source.journaltitleAnticancer research
dc.source.volume42
dc.source.issue4
dc.source.beginpage1867
dc.source.endpage1877
dc.source.countryGreece


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