Treatment of primary central nervous system lymphoma Journal Article

  


Authors: Deangelis, L. M.; Hormigo, A.
Article Title: Treatment of primary central nervous system lymphoma
Abstract: Primary central nervous system lymphoma (PCNSL) is a rare neoplasm that has captured popular attention because of its rising incidence and marked chemosensitivity. It is a non-Hodgkin's B-cell lymphoma (NHL) that appears confined to the central nervous system (CNS) at presentation but may be multifocal within the brain or involve the leptomeninges or eyes at diagnosis. Like systemic lymphoma, it is highly sensitive to corticosteroids, and administration of steroids should be withheld until the diagnosis has been confirmed histologically. Currently, the initial treatment of choice incorporates high-dose methotrexate (HD-MTX) either as a single agent or in combination with other systemic chemotherapies. Whole-brain radiotherapy (WBRT) can be a highly effective treatment modality when combined with MTX, but the combination causes an unacceptably high incidence of severe permanent neurotoxicity, particularly in patients over age 60. Therefore, chemotherapy alone is the initial treatment of choice in older patients. This approach is also being explored in younger patients, but it is possible that deferring radiotherapy may compromise disease control. Consequently, the role of radiotherapy remains to be clarified in newly diagnosed younger patients with PCNSL. © 2004 Elsevier Inc. All rights reserved.
Keywords: cancer chemotherapy; cancer survival; cancer surgery; busulfan; clinical trial; drug tolerability; fatigue; neutropenia; cancer recurrence; hepatitis; doxorubicin; drug efficacy; drug penetration; nonhuman; skin toxicity; cancer adjuvant therapy; cancer radiotherapy; combined modality therapy; cytarabine; methotrexate; rituximab; brain radiation; drug megadose; neurotoxicity; nuclear magnetic resonance imaging; apoptosis; computer assisted tomography; liver toxicity; nephrotoxicity; neoplasm recurrence, local; gene expression; bone marrow suppression; etoposide; bleeding; leukopenia; mucosa inflammation; nausea; thrombocytopenia; cyclophosphamide; dexamethasone; melphalan; vincristine; kidney failure; carmustine; lomustine; procarbazine; thiotepa; central nervous system tumor; central nervous system neoplasms; pneumonia; gastrointestinal toxicity; prednisolone; urine incontinence; stroke; folinic acid; needle biopsy; blood brain barrier; lymphoma; dementia; bleomycin; glucocorticoid; cataract; retinopathy; cognitive defect; methylprednisolone; seizure; headache; glaucoma; corticosteroid; ileus; sarcoidosis; ataxia; autologous hematopoietic stem cell transplantation; leukoencephalopathy; sclerosis; brain edema; artery injury; stereotaxic surgery; tumor cell destruction; aseptic meningitis; conjunctivitis; slit lamp; vitrectomy; eye tumor; optic nerve disease; vitreous hemorrhage; humans; prognosis; human; priority journal; article
Journal Title: Seminars in Oncology
Volume: 31
Issue: 5
ISSN: 0093-7754
Publisher: Elsevier Inc.  
Date Published: 2004-10-01
Start Page: 684
End Page: 692
Language: English
DOI: 10.1053/j.seminoncol.2004.07.011
PROVIDER: scopus
PUBMED: 15497122
DOI/URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-6344289149&partnerID=40&md5=33137024b617a3ba86fea5bb2af237e2
Notes: Semin. Oncol. -- Cited By (since 1996):36 -- Export Date: 16 June 2014 -- CODEN: SOLGA -- Source: Scopus
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MSK Authors
  1. Lisa De Angelis
    576 De Angelis
  2. Adilia Hormigo
    49 Hormigo
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