Therapeutic challenges in primary CNS lymphoma Journal Article
| Authors: | Morris, P. G.; Abrey, L. E. |
| Article Title: | Therapeutic challenges in primary CNS lymphoma |
| Abstract: | Optimum treatment for patients with primary CNS lymphoma remains challenging because there have not been any large randomised clinical trials of this rare tumour. Drugs used in treating systemic non-Hodgkin lymphoma have mostly proven ineffective because of difficulties crossing the blood-brain barrier. The recognition of the efficacy of high-dose methotrexate was a substantial therapeutic breakthrough and further advances, such as the development of polychemotherapy regimens, have built on this. Whole-brain radiotherapy can consolidate response to chemotherapy, but the associated toxic effects of chemoradiation can be unacceptable. Other effective approaches include disruption of the blood-brain barrier and the use of high-dose chemotherapy. Recently, there have been attempts to optimise multi-drug chemotherapy regimens by focusing on improving survival and reducing toxic effects. A promising area of research is the incorporation of novel targeted drugs into standard treatment frameworks. In the future, greater cooperation between research groups should hopefully lead to further therapeutic advances. © 2009 Elsevier Ltd. All rights reserved. |
| Keywords: | cancer survival; treatment outcome; unclassified drug; prednisone; clinical trial; review; cancer recurrence; doxorubicin; cancer combination chemotherapy; cancer growth; drug efficacy; monotherapy; cancer radiotherapy; radiation dose; combined modality therapy; primary central nervous system lymphoma; cytarabine; methotrexate; rituximab; temozolomide; topotecan; drug megadose; human immunodeficiency virus infection; carboplatin; multiple cycle treatment; etoposide; radiotherapy; cyclophosphamide; dexamethasone; melphalan; vincristine; autologous stem cell transplantation; stem cell transplantation; continuous infusion; drug effect; carmustine; ifosfamide; lomustine; procarbazine; thiotepa; central nervous system neoplasms; nonhodgkin lymphoma; immunotherapy; lymphoma, non-hodgkin; blood brain barrier; lymphoma; methylprednisolone; idarubicin; hydrocortisone; drug therapy; folic acid antagonist; teniposide; iarubicin; ocular lymphoma |
| Journal Title: | Lancet Neurology |
| Volume: | 8 |
| Issue: | 6 |
| ISSN: | 1474-4422 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2009-06-01 |
| Start Page: | 581 |
| End Page: | 592 |
| Language: | English |
| DOI: | 10.1016/s1474-4422(09)70091-2 |
| PUBMED: | 19446277 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 9" - "Export Date: 30 November 2010" - "CODEN: LNAEA" - "Source: Scopus" |
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