Abstract：
OBJECTIVE: Treatment intensification (including consolidative high-dose chemotherapy with autologous stem cell transplantation [HDT-ASCT]) significantly improved outcome in primary central nervous system lymphoma (PCNSL) patients.
METHODS: We conducted a multicenter, retrospective analysis of newly diagnosed PCNSL patients, treated with intensified treatment regimens. The following scores were evaluated in terms of overall survival (OS) and progression-free survival (PFS): Memorial Sloan-Kettering Cancer Center (MSKCC), International Extranodal Lymphoma Study Group (IELSG), and three-factor (3F) prognostic score. Further, all scores were comparatively investigated for model quality and concordance.
RESULTS: Altogether, 174 PCNSL patients were included. One hundred and five patients (60.3%) underwent HDT-ASCT. Two-year OS and 2-year PFS for the entire population were 73.3% and 48.5%, respectively. The MSKCC (p = .003) and 3F score (p < .001), but not the IELSG score (p = .06), had the discriminatory power to identify different risk groups for OS. In regard to concordance, the 3F score (C-index [0.71]) outperformed both the MSKCC (C-index [0.64]) and IELSG (C-index [0.53]) score. Moreover, the superiority of the 3F score was shown for PFS, successfully stratifying patients in three risk groups, which also resulted in the highest C-index (0.66).
CONCLUSIONS: The comparative analysis of established PCNSL risk scores affirm the clinical utility of the 3F score stratifying the widest prognostic spectrum among PCNSL patients treated with intensified treatment approaches.
METHODS: We conducted a multicenter, retrospective analysis of newly diagnosed PCNSL patients, treated with intensified treatment regimens. The following scores were evaluated in terms of overall survival (OS) and progression-free survival (PFS): Memorial Sloan-Kettering Cancer Center (MSKCC), International Extranodal Lymphoma Study Group (IELSG), and three-factor (3F) prognostic score. Further, all scores were comparatively investigated for model quality and concordance.
RESULTS: Altogether, 174 PCNSL patients were included. One hundred and five patients (60.3%) underwent HDT-ASCT. Two-year OS and 2-year PFS for the entire population were 73.3% and 48.5%, respectively. The MSKCC (p = .003) and 3F score (p < .001), but not the IELSG score (p = .06), had the discriminatory power to identify different risk groups for OS. In regard to concordance, the 3F score (C-index [0.71]) outperformed both the MSKCC (C-index [0.64]) and IELSG (C-index [0.53]) score. Moreover, the superiority of the 3F score was shown for PFS, successfully stratifying patients in three risk groups, which also resulted in the highest C-index (0.66).
CONCLUSIONS: The comparative analysis of established PCNSL risk scores affirm the clinical utility of the 3F score stratifying the widest prognostic spectrum among PCNSL patients treated with intensified treatment approaches.
摘要：
目的：强化治疗（包括合并大剂量化疗联合自体干细胞移植[HDT-ASCT]）可显著改善原发性中枢神经系统淋巴瘤（PCNSL）患者的预后。
方法：我们进行了多中心，新诊断PCNSL患者的回顾性分析，用强化治疗方案治疗。根据总生存期（OS）和无进展生存期（PFS）评估以下得分：纪念斯隆-凯特琳癌症中心（MSKCC），国际结外淋巴瘤研究组（IELSG），和三因素（3F）预后评分。Further,对所有评分的模型质量和一致性进行了比较研究.
结果：总之，包括174例PCNSL患者。105名患者(60.3%)接受了HDT-ASCT。整个人口的两年OS和两年PFS分别为73.3％和48.5％，分别。MSKCC（p=.003）和3F得分（p<.001），但不是IELSG得分（p=.06），具有辨别能力，可以识别操作系统的不同风险组。关于和谐，3F评分(C指数[0.71])优于MSKCC评分(C指数[0.64])和IELSG评分(C指数[0.53]).此外，PFS显示3F评分的优越性，成功地将患者分为三个风险组，这也导致了最高的C指数(0.66)。
结论：对已建立的PCNSL风险评分的比较分析确认了3F评分的临床实用性，该评分对接受强化治疗方法治疗的PCNSL患者中最广泛的预后谱进行了分层。
方法：我们进行了多中心，新诊断PCNSL患者的回顾性分析，用强化治疗方案治疗。根据总生存期（OS）和无进展生存期（PFS）评估以下得分：纪念斯隆-凯特琳癌症中心（MSKCC），国际结外淋巴瘤研究组（IELSG），和三因素（3F）预后评分。Further,对所有评分的模型质量和一致性进行了比较研究.
结果：总之，包括174例PCNSL患者。105名患者(60.3%)接受了HDT-ASCT。整个人口的两年OS和两年PFS分别为73.3％和48.5％，分别。MSKCC（p=.003）和3F得分（p<.001），但不是IELSG得分（p=.06），具有辨别能力，可以识别操作系统的不同风险组。关于和谐，3F评分(C指数[0.71])优于MSKCC评分(C指数[0.64])和IELSG评分(C指数[0.53]).此外，PFS显示3F评分的优越性，成功地将患者分为三个风险组，这也导致了最高的C指数(0.66)。
结论：对已建立的PCNSL风险评分的比较分析确认了3F评分的临床实用性，该评分对接受强化治疗方法治疗的PCNSL患者中最广泛的预后谱进行了分层。
