Treatment of primary CNS lymphoma

Current Treatment Options in Neurology
Patrick RothMichael Weller

Abstract

Primary central nervous system lymphoma is a particular challenge in clinical neuro-oncology. In contrast to most other malignant brain tumors, it may be considered a curable disease at least in younger patients who can tolerate intensive treatment regimens. Yet, therapeutic progress has been limited with little measurable improvement in outcome over the last two decades, mainly due to the low incidence of this tumor, which impedes the execution of large randomized clinical trials, and the failure of most large cooperative groups to conduct such trials. Whenever possible, high-dose methotrexate (HD-MTX) is the backbone of the therapeutic regimen. Response rates can be increased by the addition of second agents like ifosfamide or cytarabine, however, their impact on overall survival is less clear. Similarly, the use of the anti-CD20 antibody rituximab, commonly used in the treatment of B cell lymphomas outside the CNS, remains controversial and has not been examined in adequate clinical trials. The prognosis of patients, who do not qualify for HD-MTX-based chemotherapy, is considerably poorer. Radiation therapy is an active treatment with high response rates but does typically not result in long-lasting remissions. It remains an...Continue Reading

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Citations

Dec 24, 2014·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Patrick RothMichael Weller
Jun 3, 2015·Neuro-oncology Practice·Patrick RothMichael Weller
Oct 15, 2014·Current Opinion in Neurology·Patrick Roth, Khê Hoang-Xuan
May 19, 2020·Journal of Cellular Physiology·Hua YangHua You
Mar 8, 2016·Clinical Endocrinology·Sarah CatfordRosemary Wong

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