Primary CNS Lymphoma Treatment (PDQ®)–Health Professional Version

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Changes to This Summary (10/28/2016)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Treatment Option Overview for Primary CNS Lymphoma

Added Ferreri et al. as reference 34.

Added text to state that in a phase II study of 32 patients, induction chemotherapy with rituximab plus methotrexate plus procarbazine plus vincristine was consolidated with high-dose chemotherapy with thiotepa, cyclophosphamide, and busulfan, followed by autologous stem cell transplant (ASCT) and no whole-brain radiation therapy (WBRT). Also added statistics for median follow-up (cited Omuro et al. as reference 36 and level of evidence 3iiiDiv).

Added text to state that several prospective randomized trials are comparing the value of WBRT and the value of ASCT as consolidation after high-dose methotrexate induction therapy; named the studies involved.

Added text to state that in a prospective randomized trial of 410 immunocompetent patients with newly diagnosed primary central nervous system lymphoma, all patients were scheduled to receive high-dose methotrexate and randomly assigned to receive WBRT or no radiation. Also added statistics about the intent-to-treat population, including data that showed the association of WBRT with a prolongation of progression-free survival but no difference in overall survival; the study lacked the power to exclude a benefit or harm from the WBRT (cited Korfel et al. as reference 46 and level of evidence 1iiDiii). In this study, 19 patients were diagnosed with intraocular involvement at diagnosis; intraocular lymphoma was an independent negative prognostic indicator (cited Kreher et al. as reference 47).

Added text to state that patients with intraocular disease and concomitant brain involvement had a worse prognosis than those with brain-involvement alone.

Added Key References for Primary CNS Lymphoma Treatment as a new section.

This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® - NCI's Comprehensive Cancer Database pages.

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