PRIMARY CENTRAL-NERVOUS-SYSTEM LYMPHOMA - TREATMENT WITH MULTIAGENT SYSTEMIC AND INTRATHECAL CHEMOTHERAPY WITH RADIATION-THERAPY

Nine patients with primary central nervous system lymphoma (PCNSL) wer e evaluated in a protocol of systemic and intrathecal chemotherapy and radiation therapy (RT). The median survival was 30 months; median tim e to recurrence was 14 months. Leukoencephalopathy developed in 7/9 pa tients, 6-12 months after combination therapy. 5/9 patients worsened c ognitively 6-14 months after therapy; all developed leukoencephalopath y. The four patients who had an initial positive cytology or delayed C SF outflow did not worsen cognitively, although two developed leukoenc ephalopathy. The combination of chemotherapy and RT improves survival of patients with PCNSL; however, leukoencephalopathy and cognitive cha nges are frequent.