PRIMARY CEREBRAL NON-HODGKINS-LYMPHOMA (PCNSL) - A REVIEW OF NEW TRENDS IN MANAGEMENT

Primary central nervous system lymphoma (PCNSL) is a rare tumor but it is rising in incidence in both AIDS and non AIDS populations. It is a non-Hodgkin's lymphoma that usually presents itself as a brain tumor, but leptomeninges, eyes and also spinal cord are frequently affected. The management of PCNSL patients has evolved in the last years. The r ole of surgery has been restricted for diagnosis only because the exer esis of the tumor is ineffective owing to its multifocal and infiltrat ive nature. Therefore, stereotactic biopsy is the way of choice for do cumenting the diagnosis. The standard treatment was radiotherapy starr ed after diagnosis and followed by chemotherapy at recurrence, PCNSL i s radiosensitive and chemosensitive: about 70% of patients respond to one or other of these treatment modalities but usually PCNSL recurs lo cally after radiotherapy. More recently the inclusion of high doses AR A-C and Methotrexate delivered prior radiotherapy have shown significa nt high responses and prolonged survivals.