Topics:
Hematologic Malignancies • Radiation Oncology • Neuro-Oncology • Medical Oncology • Lymphoma • Hematology
How do you decide on the modality of consolidative treatment after a CR in primary CNS lymphoma patients treated with a high-dose methotrexate regimen?
How do you decide between WBRT, maintenance chemotherapy, or stem cell transplantation?
Answer from: Medical Oncologist at Academic Institution
Unless there are contraindications to autologous transplant I favor consolidation with autologous transplant. The long term complications of whole brain XRT include significant neurocognitive deficits. These approaches are rough equal with regards to efficacy.
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Answer from: Medical Oncologist at Community Practice
Another consolidative option is non-myeloablative chemotherapy with etoposide plus cytarabine (EA) based on the CALGB 50202 trial (Rubenstein et al., JCO 2013) using MTR induction, followed by consolidation EA. In that trial, the 2-year time to progression was 59%, and for patients who completed con...