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      Diagnosis and treatment of primary CNS lymphoma in immunocompetent patients: guidelines from the European Association for Neuro-Oncology.

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          Abstract

          The management of primary CNS lymphoma is one of the most controversial topics in neuro-oncology because of the complexity of the disease and the very few controlled studies available. In 2013, the European Association of Neuro-Oncology created a multidisciplinary task force to establish evidence-based guidelines for immunocompetent adults with primary CNS lymphoma. In this Review, we present these guidelines, which provide consensus considerations and recommendations for diagnosis, assessment, staging, and treatment of primary CNS lymphoma. Specifically, we address aspects of care related to surgery, systemic and intrathecal chemotherapy, intensive chemotherapy with autologous stem-cell transplantation, radiotherapy, intraocular manifestations, and management of elderly patients. The guidelines should aid clinicians in their daily practice and decision making, and serve as a basis for future investigations in neuro-oncology.

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          Author and article information

          Journal
          Lancet Oncol.
          The Lancet. Oncology
          1474-5488
          1470-2045
          Jul 2015
          : 16
          : 7
          Affiliations
          [1 ] Assistance Publique des Hôpitaux de Paris, Department of Neurology Mazarin, Hôpital Pitié-Salpêtrière, Université Pierre et Marie Curie, Institut Hospitalo-Universitaire, Institut du Cerveau et de la Moelle, Inserm Unit 1125, UMR Unit 7225, Lymphome Oculo Cerebral Network, Paris, France. Electronic address: khe.hoang-xuan@psl.aphp.fr.
          [2 ] Department of Clinical Oncology, Nottingham City Hospital, Nottingham, UK.
          [3 ] Department of Neuro-Oncology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, Netherlands.
          [4 ] Departments of Neurology and Oncology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
          [5 ] Department of Medicine I and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
          [6 ] Department of Neuro-Oncology, University of Turin and City of Health and Science Hospital, Turin, Italy.
          [7 ] Department of Neurology, University Hospital Bochum, Knappschaftskrankenhaus, Bochum, Germany.
          [8 ] Center for Neuro-Oncology, Davidoff Institute of Oncology, Rabin Medical Center, Campus Beilinson, Petach Tikva, Israel.
          [9 ] Hematology Department, Hôpital René Huguenin-Institut Curie, Saint-Cloud, Paris, France; Collège de France, CNRS UMR 7241/INSERM U1050, Paris, France.
          [10 ] Radiation Oncology Department, Neolife Medical Center, Besiktas, Istanbul, Turkey.
          [11 ] Department of Ophthalmology, Institut Curie, Paris, France.
          [12 ] Department of Neuropathology, University of Cologne, Cologne, Germany.
          [13 ] Department of Neurosurgery, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands.
          [14 ] Unit of Lymphoid Malignancies and Division of Onco-hematological Medicine, Department of Onco-hematology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
          [15 ] Department of Neurology, Hospital Clinic, Barcelona, Spain.
          [16 ] Regional Cancer Center Stockholm County, Stockholm, Sweden and Department of Radiation Sciences & Oncology, Umeå University, Umea, Sweden.
          [17 ] Division of Clinical Neuro-Oncology, Department of Neurology, University of Bonn Medical Center, Bonn, Germany.
          [18 ] Department of Neurology, Medical Center Haaglanden, The Hague, Netherlands; Department of Neurology, VU University Medical Centre, Amsterdam, Netherlands.
          [19 ] Department of Neurology, University Hospital Zürich, Zürich, Switzerland.
          Article
          S1470-2045(15)00076-5
          10.1016/S1470-2045(15)00076-5
          26149884
          9973cc85-48b6-495b-831b-ed10ccb4c69e
          Copyright © 2015 Elsevier Ltd. All rights reserved.
          History

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