Pierwotny chłoniak ośrodkowego układu nerwowego u pacjentów immunokompetentnych

摘要: Primary central nervous system lymphoma (PCNSL) is a rare malignancy, exclusively arising in (CNS) and the intraocular compartment, accounting for 4% of all intracranial tumors. Recently, incidence PCNSL progressively increasing immunocompetent patients elderly age group. CNS involvement diffuse large B cell (DLBCL) histology 95% cases are responsible an aggressive clinical course this malignancy. Particular microenvironment blood-brain barrier (BBB) strongly affect therapeutic approach. Namely R-CHOP regimen being standard treatment systemic DLBCL not sufficient because its poor ability to cross barrier. Therefore, chemotherapy incorporating high-dose methotrexate, able BBB radiotherapy backbone treatment. Although combined modality has improved outcomes regarding alone, it can induce severe neurotoxicity (radiotherapy main cause), particularly older than 60 years. recent studies have addressed question how optimize order avoid up-front without worsening results. High-dose together with autologous stem transplantation another option younger patients, whereas disruption (BBBD) followed by intra-arterial regarded as experimental modality.