Journal Club: Randomized phase III study of whole-brain radiotherapy for primary CNS lymphoma

Abstract

Primary CNS lymphoma (PCNSL) is a rare aggressive variant of extranodal non-Hodgkin lymphoma (NHL) that involves the brain, leptomeninges, eyes, or spinal cord. PCNSL is primarily treated with systemic high-dose methotrexate. The role of combining chemotherapy with whole-brain radiation therapy (WBRT) has been debated as WBRT is linked to delayed neurotoxicity, especially in patients older than 60 years. 1 In 1999, the German PCNSL group initiated the largest and only phase III trial to date evaluating whether the omission of WBRT compromises OS in immunocompetent patients with PCNSL. The initial report at a median follow-up of 31.8 months was published in 2010. 2 The updated version at a median follow-up of 81.2 months was recently published in Neurology®. 3