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Overall Management > Lymphomas and Haemopoietic Neoplasms
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40th
ASCO Annual Meeting. New Orleans, LA. June 5-8, 2004. Session: An
Update on Primary Brain Tumors (Education Program)
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Meeting Abstract |
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Update on Primary Central Nervous System Lymphoma
Lisa M. DeAngelis, MD
Primary CNS lymphoma (PCNSL) is a non-Hodgkin's lymphoma restricted to the
CNS.
PCNSL usually presents as a parenchymal brain mass but may also involve the
subarachnoid space and the eyes.
Clinical symptoms and signs are typical of an intracranial space-occupying
lesion that can be multiple in approximately 40% of patients.
The diagnosis is usually established by stereotactic biopsy, and the majority of
PCNSLs are diffuse large cell B-cell lymphomas.
Temporary disease regression can occur with corticosteroids, but definitive
therapy requires chemotherapy and occasionally cranial irradiation.
High-dose methotrexate is the most active agent in the treatment of this disease
and should be considered in the initial therapy for every patient regardless of
age.
When used, cranial irradiation must be delivered to the whole brain to treat the
diffuse multifocal microscopic disease that may not be apparent on
neuroimaging.
However, radiotherapy should be avoided in all patients who are age 60 or older
and must be carefully considered in any patient over the age of 45 because of
the high risk of late neurotoxicity that can develop in those who have received
cranial radiotherapy and chemotherapy.
With current approaches, median survival can approach 60 months, and some
patients are cured.
Even those with recurrent disease can often achieve a second remission with
additional treatment.
Copyright 2004 American Society of Clinical Oncology All rights
reserved worldwide.
Full Article: A PDF download of the full article is available to members only.
Source: http://www.asco.org/ac/1,1003,_12-002673-00_18-0026-00_19-00110-00_21-001-00_29-00E,00.asp
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