Primary central nervous system lymphoma surgery: Difference between revisions
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==Overview== | ==Overview== | ||
[[surgery|Surgical intervention]] is not recommended for the management of primary central nervous system lymphoma, because the tumors are often deeply seated and spread throughout the brain. | [[surgery|Surgical intervention]] is not recommended for the management of primary central nervous system lymphoma, because the tumors are often deeply seated and spread throughout the brain. | ||
==Surgery== | ==Surgery== | ||
*[[Surgery]] does not play a role in the treatment of primary central nervous system lymphoma because the tumors are often spread throughout the brain and located deep within the brain.<ref name=treatmentofprimarycentralnervoussystemlymphoma1>Treatment of primary central nervous system lymphoma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/primary-cns-lymphoma/?region=on. Accessed on February 18, 2016</ref> | *[[Surgery]] does not play a role in the treatment of primary central nervous system lymphoma because the tumors are often spread throughout the brain and located deep within the brain.<ref name="treatmentofprimarycentralnervoussystemlymphoma1">Treatment of primary central nervous system lymphoma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/primary-cns-lymphoma/?region=on. Accessed on February 18, 2016</ref> | ||
*A surgery for [[stereotactic|stereotactic biopsy]] may be done to make a diagnosis.<ref name=treatmentofprimarycentralnervoussystemlymphoma1>Treatment of primary central nervous system lymphoma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/primary-cns-lymphoma/?region=on. Accessed on February 18, 2016</ref> | *A surgery for [[stereotactic|stereotactic biopsy]] may be done to make a diagnosis.<ref name="treatmentofprimarycentralnervoussystemlymphoma1">Treatment of primary central nervous system lymphoma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/primary-cns-lymphoma/?region=on. Accessed on February 18, 2016</ref> | ||
*Surgical resection is usually ineffective because of the depth of the tumor. | |||
*Treatment with irradiation and corticosteroids often only produces a partial response, but tumor recurs in more than 90% of patients. | |||
*Median survival is 10 to 18 months in immunocompetent patients, and less in those with AIDS. | |||
*The addition of IV [[methotrexate]] and citrovorum may extend survival to a median of 3.5 years. If radiation is added to methotrexate, median survival may increase beyond 4 years. | |||
*Radiation is not recommended in conjunction with methotrexate because of increased risk of leukoencephalopathy and dementia in patients older than 60 years of age<ref>Deangelis LM, Hormigo A. Treatment of primary central nervous system lymphoma. ''Semin Oncol'' 2004; 31:684-692. In AIDS patients, perhaps the most important factor with respect to treatment is the use of highly active anti-retroviral therapy (HAART), which affects the CD4+ lymphocyte population and the level of immunosuppression</ref> | |||
==References== | ==References== |
Latest revision as of 17:45, 20 May 2019
Primary central nervous system lymphoma Microchapters |
Differentiating Primary Central Nervous System Lymphoma from other Diseases |
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Primary central nervous system lymphoma surgery On the Web |
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Risk calculators and risk factors for Primary central nervous system lymphoma surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Overview
Surgical intervention is not recommended for the management of primary central nervous system lymphoma, because the tumors are often deeply seated and spread throughout the brain.
Surgery
- Surgery does not play a role in the treatment of primary central nervous system lymphoma because the tumors are often spread throughout the brain and located deep within the brain.[1]
- A surgery for stereotactic biopsy may be done to make a diagnosis.[1]
- Surgical resection is usually ineffective because of the depth of the tumor.
- Treatment with irradiation and corticosteroids often only produces a partial response, but tumor recurs in more than 90% of patients.
- Median survival is 10 to 18 months in immunocompetent patients, and less in those with AIDS.
- The addition of IV methotrexate and citrovorum may extend survival to a median of 3.5 years. If radiation is added to methotrexate, median survival may increase beyond 4 years.
- Radiation is not recommended in conjunction with methotrexate because of increased risk of leukoencephalopathy and dementia in patients older than 60 years of age[2]
References
- ↑ 1.0 1.1 Treatment of primary central nervous system lymphoma. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/primary-cns-lymphoma/?region=on. Accessed on February 18, 2016
- ↑ Deangelis LM, Hormigo A. Treatment of primary central nervous system lymphoma. Semin Oncol 2004; 31:684-692. In AIDS patients, perhaps the most important factor with respect to treatment is the use of highly active anti-retroviral therapy (HAART), which affects the CD4+ lymphocyte population and the level of immunosuppression