Radiotherapy for newly diagnosed primary central nervous system lymphoma: role and perspective.
Alice ThomasCaroline HouillierDelphine AntoniKhe Hoang-XuanCarole SoussainJulian JacobLoic FeuvretPublished in: Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology (2023)
Whole brain radiotherapy (WBRT) has long been a key treatment of newly diagnosed primary central nervous system lymphoma (PCNSL). In the 1990s, the addition of high dose Methotrexate-based induction chemotherapy (HD MTX-based CT) has enabled a drastic improvement in PCNSL patients outcome. However, combined treatment has led to radiation-induced delayed neurotoxicity, especially in older patients. Alternative treatment strategies have been assessed to improve the efficacy and neurotoxicity ratio. Nowadays, in the elderly patients WBRT is widely omitted or deferred, and in younger patients WBRT is challenged by high dose chemotherapy with autologous stem cell transplant (HCT-ASCT) for consolidation treatment after HD MTX-based CT. In this setting, this review is addressed to clinicians with the aim to summarize the role of WBRT in the treatment of newly diagnosed PCNSL and its perspectives.
Keyphrases
- newly diagnosed
- high dose
- radiation induced
- stem cells
- end stage renal disease
- low dose
- ejection fraction
- early stage
- computed tomography
- locally advanced
- magnetic resonance imaging
- small cell lung cancer
- mesenchymal stem cells
- palliative care
- prognostic factors
- multiple sclerosis
- magnetic resonance
- brain metastases
- peritoneal dialysis
- diffuse large b cell lymphoma
- patient reported outcomes
- white matter
- brain injury
- patient reported
- subarachnoid hemorrhage