Objective  To investigate the treatment, clinical characteristics, and outcomes of patients with primary central nervous system lymphoma (PCNSL).

  Methods  A total of 75 patients histologically confirmed with PCNSL from November 2011 to November 2015 in the frist affiliated hospital of Zhengzhou Unversity were enrolled in this retrospective study. The clinical characteristics, treatment outcomes and prognostic factors of the patients were analyzed. The Kaplan-Meier method was used for univariate analysis of survival, with assessment of differences by the Log-rank test. Multivariate analysis was performed using the Cox proportional hazards model.

  Results  The median age at diagnosis of the 75 patients with PCNSL was 55 years (range: 9-79 years), and a male-to-female ratio of 1.1: 1 was observed. Major clinical characteristics observed in the patients were increased intracranial pressure and focal neurological deficits. All patients were diagnosed with diffuse large B-cell lymphoma (DLBCL). Of the 69 patients with follow-up data, the median progression-free survival (PFS) of the chemotherapy combined with radiotherapy group (n=25), chemotherapy group (n=28), radiotherapy group (n=9) and surgery group (n=7) were 23.6 (95% CI: 16.0-31.3), 6.4 (1.0-11.8), 9.8 (4.7-14.9), and 5.0 (4.9-5.2) months, respectively. The median overall survival (OS) of these four groups was 45.7 (95% CI: 44.2-47.2), 11.0 (7.1-15.0), 16.1 (15.3-17.0), and 6.9 (1.9-12.0) months, respectively. All differences in PFS and OS between the groups were statistically significant (all P < 0.01). No statistical differences were observed in the incidence of treatment-induced toxicity among these groups (P > 0.05). Survival analysis showed that both age and Eastern Cooperative Oncology Group (ECOG) performance status were significantly associated with OS, and thus were independent risk factors.

  Conclusions  PCNSL predominantly occurred in elderly people. Diffuse large B-cell lymphoma was the main type of PCNSL diagnosed. Increased intracranial pressure and focal neurological deficits were the major clinical characteristics of the patients. Age (60 years or younger), ECOG performance status score≤1, and the comprehensive treatment modality were significantly associated with improved OS.