The role of whole brain radiation in primary CNS lymphoma

Abstract

A 63-year-old woman presented with progressive dizziness and headaches. A brain magnetic resonance imaging (MRI) revealed a 3 3 4 cm contrast enhancing single mass in the right parietal lobe; stereotactic biopsy of themass revealed aCD20-positive diffuse large B-cell lymphoma (DLBCL). Body fluorodeoxyglucose-positron emission tomography scan and bone marrow biopsy were negative. The patient had no other health issues. She had good performance status when starting treatment with the combination of rituximab, high-dose methotrexate (HD-MTX) (3.5 g/m2), and high-dose cytarabine (HD-Ara-C) (2 3 2 g/m2). After 4 courses, she achieved a partial radiographic response. After 2 more courses, she achieved a complete radiographic response. After achieving complete response (CR), myeloablative, nonmyeloablative chemotherapy, or whole brain radiotherapy (WBRT) were considered as consolidative treatments to reduce the risk of relapse.