原文不变：Primary central nervous system lymphoma (PCNSL) is an aggressive subtype of non-Hodgkin lymphoma that carries a poor prognosis in the elderly. The aim of this study is to investigate treatment patterns and survival trends in patients ≥ 65 years with PCNSL through data provided by the Texas Cancer Registry. Adults ≥ 65 years diagnosed with PCNSL and followed between 1995-2017 were identified and separated into three eras: 1995-2003, 2004-2012, and 2013-2017. Baseline covariates compared included patient demographics and treatments administered. Pearson's chi-squared test and Cox proportional hazard models compared covariates; overall survival (OS) and disease-specific survival (DSS) were assessed via Kaplan-Meier methodology. There were 375 patients; 104 (27.7%) in 1995-2003, 146 (38.9%) in 2004-2012, and 125 (33.3%) in 2013-2017. There were 50 (48.1%), 55 (37.7%), and 31 (24.8%) in 1995-2003, 2004-2012, and 2013-2017, respectively, that did not receive treatment. At last follow up, 101 (97.1%), 130 (89.0%), and 94 (75.2%) in each era died, of which 89 (85.6%), 112 (76.7%), and 70 (56.0%) were attributed to PCNSL. Median OS per era was eight (95% confidence interval [CI] 5.06-10.93), six (95% CI, 2.30-9.69), and five months (95% CI, 2.26-7.73) (p = 0.638). DSS per era was nine (95% CI: 0.00, 26.53), 10 (95% CI: 5.14, 14.86), and 19 (95% CI, 0.00-45.49) (p = 0.931) months. Spinal cord as primary disease site (HR: 0.668 [95% CI, 0.45-0.99], p = 0.049), and chemotherapy (HR 0.532 [95% CI, 0.42-0.673], p =  < 0.001) or chemotherapy + radiation (HR, 0.233 [95% CI, 0.11-0.48] p < 0.001) had better outcomes compared to no therapy or radiation therapy alone. Survival in older patients ≥ 65 with PCNSL has not improved per our analysis of the TCR from 1995-2017 despite increasing trends of treatment utilization. Strategies to augment recruitment of older individuals in trials are needed in order to determine who would derive treatment benefit and minimize treatment toxicities.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. 主要中枢神经系统淋巴瘤（PCNSL）是非霍奇金淋巴瘤的一种侵袭性亚型，在老年人中具有恶劣的预后。本研究旨在通过德克萨斯州癌症登记资料，研究65岁及以上PCNSL患者的治疗模式和生存趋势。诊断为PCNSL的65岁及以上成年患者，在1995年至2017年之间随访，并分为三个时期：1995-2003年，2004-2012年和2013-2017年。比较基线协变量包括患者人口统计学和治疗管理。使用Pearson卡方检验和Cox比例危险模型进行协变量比较；通过Kaplan-Meier方法评估总体生存期和疾病特异性生存期。共有375名患者；104名（27.7％）在1995-2003年，146名（38.9％）在2004-2012年，125名（33.3％）在2013-2017年。分别有1995-2003年，2004-2012年和2013-2017年的50名（48.1％），55名（37.7％）和31名（24.8％）未接受治疗。最后一次随访时，在每个时期，分别有101名（97.1％），130名（89.0％）和94名（75.2％）患者死亡，其中89名（85.6％），112名（76.7％）和70名（56.0％）归因于PCNSL。每个时期的中位OS分别为8（95％置信区间[CI] 5.06-10.93），6（95％CI，2.30-9.69）和5个月（95％CI，2.26-7.73）（p = 0.638）。每个时期的DSS分别为9（95％CI：0.00、26.53），10（95％CI：5.14、14.86）和19（95％CI，0.00-45.49）(p = 0.931)个月。以脊髓为主要疾病部位（HR：0.668[95％CI，0.45-0.99]，p = 0.049）和化疗（HR 0.532 [95％CI，0.42-0.673]，p <0.001）或化疗+放疗（HR，0.233 [95％CI，0.11-0.48] p <0.001）的预后比无治疗或单独的放疗治疗要好。尽管治疗利用率逐渐增加，但我们对1995-2017年TCR分析表明，65岁及以上PCNSL患者的生存情况并没有得到改善。需要制定策略来增加老年人参与试验，以确定谁将获得治疗效益并最小化治疗毒性。©2023. 作者在Springer-Verlag GmbH Germany的独家许可下，属于Springer Nature。

Primary central nervous system lymphoma (PCNSL) is an aggressive subtype of non-Hodgkin lymphoma that carries a poor prognosis in the elderly. The aim of this study is to investigate treatment patterns and survival trends in patients ≥ 65 years with PCNSL through data provided by the Texas Cancer Registry. Adults ≥ 65 years diagnosed with PCNSL and followed between 1995-2017 were identified and separated into three eras: 1995-2003, 2004-2012, and 2013-2017. Baseline covariates compared included patient demographics and treatments administered. Pearson's chi-squared test and Cox proportional hazard models compared covariates; overall survival (OS) and disease-specific survival (DSS) were assessed via Kaplan-Meier methodology. There were 375 patients; 104 (27.7%) in 1995-2003, 146 (38.9%) in 2004-2012, and 125 (33.3%) in 2013-2017. There were 50 (48.1%), 55 (37.7%), and 31 (24.8%) in 1995-2003, 2004-2012, and 2013-2017, respectively, that did not receive treatment. At last follow up, 101 (97.1%), 130 (89.0%), and 94 (75.2%) in each era died, of which 89 (85.6%), 112 (76.7%), and 70 (56.0%) were attributed to PCNSL. Median OS per era was eight (95% confidence interval [CI] 5.06-10.93), six (95% CI, 2.30-9.69), and five months (95% CI, 2.26-7.73) (p = 0.638). DSS per era was nine (95% CI: 0.00, 26.53), 10 (95% CI: 5.14, 14.86), and 19 (95% CI, 0.00-45.49) (p = 0.931) months. Spinal cord as primary disease site (HR: 0.668 [95% CI, 0.45-0.99], p = 0.049), and chemotherapy (HR 0.532 [95% CI, 0.42-0.673], p =  < 0.001) or chemotherapy + radiation (HR, 0.233 [95% CI, 0.11-0.48] p < 0.001) had better outcomes compared to no therapy or radiation therapy alone. Survival in older patients ≥ 65 with PCNSL has not improved per our analysis of the TCR from 1995-2017 despite increasing trends of treatment utilization. Strategies to augment recruitment of older individuals in trials are needed in order to determine who would derive treatment benefit and minimize treatment toxicities.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.