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The outcome for immunocompetent patients with primary CNS lymphoma (PCNSL) has improved substantially due to combined therapy with whole-brain radiotherapy (WBRT) and chemotherapy using methotrexate and cytarabine or high-dose methotrexate (HD-MTX).1-3 Concerning therapy for patients with progression during first-line therapy (6.4%)1 or with relapse after initial complete response (CR; 34 to 40%),1,3 the best results were reported with WBRT after failure of HD-MTX–containing regimens (CR in 6 of 12 patients3 or in all 4 patients4) and with cytarabine after DeAngelis’ combined modality therapy (CR in 3 of 8 patients).5
Radiochemotherapy according to DeAngelis et al.1 and, since 1998, HD-MTX (8 g/m2 body surface area)3 were primary treatments for patients with PCNSL at our institution. All patients presenting with recurrent or progressive PCNSL between 1995 and 1998 were intended to be treated with PCV chemotherapy (procarbazine 60 mg/m2, days 8 through 21; lomustine (CCNU) 110 mg/m2, day 1; vincristine 2 mg, days 8 and 29) …
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