Background: Primary CNS Lymphoma is a rare and severe but potentially curable disease. In the last thirty years treatment has changed significantly. Survival times increased due to high-dose methotrexate-based chemotherapy. With intensive regimens involving autologous stem cell transplantation (ASCT), 4-year survival rates of more than 80% can be reached. However, this treatment regimen is not feasible in all patients, and is associated with some mortality. Methods: In this review, current evidence regarding the efficacy and toxicity of radiotherapy in PCNSL shall be summarized and discussed mainly based on data of controlled trials. Results: Being the first feasible treatment whole brain radiotherapy (WBRT) was initially used alone, and later as a consolidating treatment after high-dose methotrexate-based chemotherapy. More recently, concerns regarding activity and neurotoxicity of standard dose WBRT limited its use. On the contrary, latest evidence of some phase II trials suggests efficacy of consolidating WBRT is comparable to ASCT. After complete remission reduced dose WBRT appears as a feasible concept with decreased neurotoxicity. Evidence for use of local stereotactic radiotherapy is very limited. Conclusion: Radiotherapy has a role in the treatment of PCNSL patients not suitable to ASCT, e.g., as consolidating reduced dose WBRT after complete response. Local stereotactic radiotherapy for residual disease should be examined in future trials.
Background: Primary CNS Lymphoma is a rare and severe but potentially curable disease. In the last thirty years treatment has changed significantly. Survival times increased due to high-dose methotrexate-based chemotherapy. With intensive regimens involving autologous stem cell transplantation (ASCT), 4-year survival rates of more than 80% can be reached. However, this treatment regimen is not feasible in all patients, and is associated with some mortality. Methods: In this review, current evidence regarding the efficacy and toxicity of radiotherapy in PCNSL shall be summarized and discussed mainly based on data of controlled trials. Results: Being the first feasible treatment whole brain radiotherapy (WBRT) was initially used alone, and later as a consolidating treatment after high-dose methotrexate-based chemotherapy. More recently, concerns regarding activity and neurotoxicity of standard dose WBRT limited its use. On the contrary, latest evidence of some phase II trials suggests efficacy of consolidating WBRT is comparable to ASCT. After complete remission reduced dose WBRT appears as a feasible concept with decreased neurotoxicity. Evidence for use of local stereotactic radiotherapy is very limited. Conclusion: Radiotherapy has a role in the treatment of PCNSLpatients not suitable to ASCT, e.g., as consolidating reduced dose WBRT after complete response. Local stereotactic radiotherapy for residual disease should be examined in future trials.
Authors: Ulrich Herrlinger; Niklas Schäfer; Rolf Fimmers; Frank Griesinger; Michael Rauch; Heinz Kirchen; Patrick Roth; Martin Glas; Michael Bamberg; Peter Martus; Eckhard Thiel; Agnieszka Korfel; Michael Weller Journal: J Cancer Res Clin Oncol Date: 2017-04-22 Impact factor: 4.553
Authors: Antonio M P Omuro; Leah S Ben-Porat; Katherine S Panageas; Amy K Kim; Denise D Correa; Joachim Yahalom; Lisa M Deangelis; Lauren E Abrey Journal: Arch Neurol Date: 2005-10
Authors: Paul L Nguyen; Arnab Chakravarti; Dianne M Finkelstein; Fred H Hochberg; Tracy T Batchelor; Jay S Loeffler Journal: J Clin Oncol Date: 2005-03-01 Impact factor: 44.544
Authors: Eric L Chang; Jeffrey S Wefel; Kenneth R Hess; Pamela K Allen; Frederick F Lang; David G Kornguth; Rebecca B Arbuckle; J Michael Swint; Almon S Shiu; Moshe H Maor; Christina A Meyers Journal: Lancet Oncol Date: 2009-10-02 Impact factor: 41.316
Authors: Matthijs van der Meulen; Linda Dirven; Esther J J Habets; Martin J van den Bent; Martin J B Taphoorn; Jacoline E C Bromberg Journal: Lancet Oncol Date: 2018-08 Impact factor: 41.316
Authors: Florian Scheichel; Daniel Pinggera; Branko Popadic; Camillo Sherif; Franz Marhold; Christian Franz Freyschlag Journal: Front Oncol Date: 2022-04-20 Impact factor: 5.738