Journal article
Stereotactic Radiosurgery for Primary Central Nervous System Lymphoma: Results From the International Radiosurgery Research Foundation
Neurosurgery
14 Jan 2026
PMID: 41532758
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Abstract
Stereotactic radiosurgery (SRS) has been increasingly employed in the multimodal management of primary central nervous system lymphoma. Here, we evaluate the outcomes of SRS for the treatment of primary central nervous system lymphoma through a multicenter, international cohort study.
A multicenter, retrospective cohort study was conducted through the International Radiosurgery Research Foundation. Subgroups were defined according to treatment setting: up-front (primary treatment), boost (SRS after consolidative chemotherapy with or without whole-brain radiotherapy), and relapsed/refractory (recurrent/progressive disease after first-line therapy). The primary end point was local tumor control. Time-to-event analysis was conducted using the Kaplan-Meier method. Variables associated with local control were assessed using the Cox proportional hazard modeling.
Fifty-four patients with 127 tumor sites were included in this analysis. Actuarial 12-month local and distant control rates for the entire cohort were 75.7% and 63.7%, respectively, with a median overall survival (OS) of 18 months (range: 1-176). Actuarial 12-month local control rates were significantly different at 95.6%, 78.3%, and 42.1% (P < .0001) for the up-front, relapsed/refractory groups, and boost cohorts, respectively. OS across all cohorts were similar with 12-month OS rates of 55.2%, 51.3%, and 53.5% for the up-front, relapsed/refractory, and boost cohorts, respectively. Rates of radiation necrosis were 18.5%, 20.8%, 15.4%, and 11.8% for the entire cohort, relapsed/refractory, boost, and up-front cohorts, respectively. Diminished OS was significantly associated with treatment volumes >27 cm3 (hazard ratio: 2.5, P = .04).
SRS shows promising local tumor control rates for up-front and relapsed cohorts. Despite this, distant tumor progression limits total tumor control and may adversely affect OS.
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Details
- Title
- Stereotactic Radiosurgery for Primary Central Nervous System Lymphoma: Results From the International Radiosurgery Research Foundation
- Creators
- Trent Kite - Allegheny Health NetworkRodney E Wegner - Allegheny Health NetworkSteven Karlovits - Allegheny Health NetworkJohn Herbst - Allegheny Health NetworkJohn Lister - Allegheny Health NetworkHenry Knox - Edward Via College of Osteopathic MedicineJoshua D Palmer - The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research InstituteEugene R Yap - The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research InstituteDavid Bailey - Penn State Milton S. Hershey Medical CenterMariana Dejuk - Penn State Milton S. Hershey Medical CenterSean Mahase - Penn State Milton S. Hershey Medical CenterBrad E Zacharia - Penn State Milton S. Hershey Medical CenterChristian Amezquita-Contreras - The University of Texas Health Science Center at HoustonAngel I Blanco - The University of Texas Health Science Center at HoustonYoshua Esquenazi - The University of Texas Health Science Center at HoustonRonald E Warnick - Jewish HospitalKeiss Douri - Université de SherbrookeDavid Mathieu - Université de SherbrookeManjul Tripathi - Department of Radiation Therapy, PGIMER, Chandigarh, IndiaNarendra Kumar - Post Graduate Institute of Medical Education and ResearchCheng-Chia Lee - The Neurological InstituteHuai-Che Yang - Taipei Veterans General HospitalAnais C M A de Moura - NYU Langone HealthJheremy S Reyes - Neurological SurgeryBardia Hajkarimloo - University of VirginiaDouglas Kondziolka - NYU Langone HealthAjay Niranjan - University of Pittsburgh Medical CenterL Dade Lunsford - Neurological SurgeryJason P Sheehan - Neurological SurgeryMatthew J Shepard - Allegheny Health Network
- Publication Details
- Neurosurgery
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Other Identifier
- 991022155294004721