Dismal results in the management of PCNSL justify the need for vigorous initial therapeutic regimens. Chemotherapy should not be reserved for recurrent disease. M BACOD scheme delivered prior to irradiation was efficacious in a group of 20 PCNSL patients. CT images displayed 70% of the complete responses (CR), 15% of no responses (NR), and 15% of partial responses (PR). Half of the CR patients were scheduled for radiotherapy only at tumor recurrence. The median TTP and ST of the whole group of PCNSL, were 24 and 32 months respectively, but considering the subgroup of CR (70%) taking into account also the patients not yet receiving radiotherapy, the TTP and ST were 38 and 48 months respectively. Patients CR to chemotherapy at tumor recurrence had a second disease-free period longer than two years after radiotherapy. Our data support the knowledge that in scheduling the treatment of PCNSL, the first step is devising high-dose chemotherapy with drugs able to cross an intact BBB and that the irradiation is still effective when performed after tumor recurrence. Our primary approach with early chemotherapy in PCNSL, corroborate a consensus to continue chemotherapy until tumor recurrence, and only at that time to initiate radiotherapy. It is a challenge and an option worthy of continuing investigation.
|Number of pages||1|
|Journal||Italian Journal of Neurological Sciences|
|Publication status||Published - 1997|
ASJC Scopus subject areas
- Clinical Neurology