Primary Central Nervous System Lymphoma: Treatment Options
Until the mid-1990s, radiation was the standard therapy for patients with CNS lymphoma. Now high-dose methotrexate-based therapy is recommended for most patients in combination with other agents such as vincristine (Oncovin) and procarbazine (Matulane) plus or minus cytarabine (Cytosar-U), plus or minus rituximab (Rituxan); or with ifosfamide (Ifex) plus or minus rituximab; or with cytarabine plus or minus rituximab; or with temozolomide (Temodar) and rituximab.
Furthermore, this initial treatment (induction) is often followed by other therapy regimens (“consolidation”) to reduce the risk of recurrence. These consolidation therapies include high-dose chemotherapy alone such as cytarabine; cytarabine and etoposide; high-dose chemotherapy with stem cell transplant; or whole brain radiation therapy (WBRT). WBRT is seldom used in patients over the age of 65 because of progressive neurological complications (e.g., loss of memory or muscle coordination). If lymphoma cells are found in the spinal fluid, chemotherapy is often delivered directly into the spinal fluid, in addition to the above chemoimmunotherapy regimens.
To learn about treatments under investigation for primary central nervous system lymphoma, download the Primary Central Nervous System Lymphoma Fact Sheet.