MATILDE regimen followed by radiotherapy is an active strategy against primary CNS lymphomas

Ferreri, Andrés J.M.; Dell’Oro, Stefania; Foppoli, Marco; Bernardi, Massimo; Brandes, Alba A.; Tosoni, Alicia; Montanari, Mauro; Balzarotti, Monica; Spina, Michele; Ilariucci, Fiorella; Zaja, Francesco; Stelitano, Caterina; Bobbio, Flavio; Corazzelli, Gaetano; Baldini, Luca; Ponzoni, Maurilio; Picozzi, Piero; Cappio, F. Caligaris; Reni, Michele

doi:10.1212/01.wnl.0000210464.94122.e1

Cited by 83 publications

(37 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Three of 4 treatmentrelated deaths occurred in the combination arm (7.7%). These three studies 7,20,21 did not report TRM according to age. Of note, all 4 treatment-related deaths in our study occurred in patients aged 64 years or older.…”

Section: Discussionmentioning

confidence: 99%

Successful change of treatment strategy in elderly patients with primary central nervous system lymphoma by de-escalating induction and introducing temozolomide maintenance: results from a phase II study by The Nordic Lymphoma Group

et al. 2014

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Successful change of treatment strategy in elderly patients with primary central nervous system lymphoma by de-escalating induction and introducing temozolomide maintenance: results from a phase II study by The Nordic Lymphoma Group

et al. 2014

View full text Add to dashboard Cite

show abstract

“…2,13 Some tumors (for example, lymphoma or germinoma) are radiosensitive, and their surgical removal is excluded. 4,19 On the other hand, the most frequent type of clinical presentation is a syndrome from intracranial hypertension. This was present in 33% of our patients and was accompanied by ventricular dilation, even in tumors smaller than 10 mm in diameter, due to blockage of the CSF pathways with hydrocephalus or an entrapped ventricle.…”

Section: Discussionmentioning

confidence: 99%

“…12 Some authors have proposed obtaining a histological diagnosis by stereotactic biopsy and then, on the basis of the histological findings, deciding whether to perform surgical removal, radiotherapy, or chemotherapy. 4,8,10 Large series of patients undergoing a stereotactic biopsy have reported a mortality rate of 0.7% with a 3.5% rate of permanent morbidity. The diagnostic accuracy is 91%, but it becomes remarkably lower in midline tumors with a higher incidence of complications.…”

Section: Discussionmentioning

confidence: 99%

“…In lymphomas and pure germinomas, a regression of the tumor can be expected, restoring CSF pathways. 4,19 We believe that the histological diagnosis of tumors bulging into the lateral and third ventricles represents the first step in selecting patients for microsurgical removal, and that neuroendoscopy is a useful technique for obtaining tumor specimens and treating hydrocephalus in such cases.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Neuroendoscopic biopsy of ventricular tumors: a multicentric experience

Fiorindi

Benvenuti

et al. 2011

FOC

View full text Add to dashboard Cite

Object Although neuroendoscopic biopsy is routinely performed, the safety and validity of this procedure has been studied only in small numbers of patients in single-center reports. The Section of Neuroendoscopy of the Italian Neurosurgical Society invited some of its members to review their own experience, gathering a sufficient number of cases for a wide analysis. Methods Retrospective data were collected by 7 centers routinely performing neuroendoscopic biopsies over a period of 10 years. Sixty patients with newly diagnosed intraventricular and paraventricular tumors were included. No patient harboring a colloid cyst was included. Data regarding clinical presentation, neuroimaging findings, operative techniques, pathological diagnosis, postoperative complications, and subsequent therapy were analyzed. Results In all patients, a neuroendoscopic tumor biopsy was performed. In 38 patients (64%), obstructive hydrocephalus was present. In addition to the tumor biopsy, 32 patients (53%) underwent endoscopic third ventriculostomy (ETV), and 7 (12%) underwent septum pellucidotomy. Only 2 patients required a ventriculoperitoneal shunt shortly after the endoscopy procedure because ETV was not feasible. The major complication due to the endoscopy procedure was ventricular hemorrhage noted on the postoperative images in 8 cases (13%). Only 2 patients were symptomatic and required medical therapy. Infection occurred in only 1 case, and the other complications were all reversible. In no case did clinically significant sequelae affect the patient's outcome. Tumor types ranged across the spectrum and included glioma (low- and high-grade [27%]), pure germinoma (15%), pineal parenchymal tumor (12%), primary neuroectodermal tumor (4%), lymphoma (9%), metastasis (4%), craniopharyngioma (6%), and other tumor types (13%). In 10% of patients, the pathological findings were inconclusive. According to diagnosis, specific therapy was performed in 35% of patients: 17% underwent microsurgical removal, and 18% underwent chemotherapy or radiotherapy. Conclusions This is one of the largest series confirming the safety and validity of the neuroendoscopic biopsy procedure. Complications were relatively low (about 13%), and they were all reversible. Neuroendoscopic biopsy provided meaningful pathological data in 90% of patients, making subsequent tumor therapy feasible. Cerebrospinal fluid pathways can be restored by ETV or septum pellucidotomy (65%) to control intracranial hypertension. In light of the results obtained, a neuroendoscopic biopsy should be considered a possible alternative to the stereotactic biopsy in the diagnosis and treatment of ventricular or paraventricular tumors. Furthermore, it could be the only surgical procedure necessary for the treatment of selected tumors.

show abstract

“…HD-MTX-based combination chemotherapy together with RT and treatment of leptomeningeal disease noticeably prolongs survival when compared with RT alone (46)(47)(48)(49)(50)(51). Although most additional drugs have no proven benefit over HD-MTX alone (15,40), HD-MTX alone without immediate RT afterwards appears to produce an inferior result (52,53).…”

Section: Well-established Treatment Optionsmentioning

confidence: 99%

Limited role of surgery in the management of primary central nervous system lymphoma (Review)

Cheng¹,

Zhang²,

Zhang³

et al. 2009

Oncol Rep

View full text Add to dashboard Cite

Abstract. Primary central nervous system lymphoma (PCNSL) is a nervous-system-seeking extranodal nonHodgkin's lymphoma whose incidence has increased in both immunocompromised and immunocompetent patients. Corticosteroids are used for symptomatic management but can interfere with pathological diagnosis. The well-established treatments such as radiotherapy, chemotherapy or a combination of both remain the mainstays. Traditionally, the most important role for surgery is to obtain and sample adequate tissue to confirm a diagnosis with stereotactic biopsy. Though no benefit could be demonstrated for debulking surgery, a subset of patients with large space occupying lesions which could be well circumscribed and surgically accessible may benefit from tumor resection. Moreover, surgical procedures to carry out interstitial chemotherapy and/or brachytherapy with or without tumor resection hold promise. Complications such as hydrocephalus could be managed by ventriculoperitoneal shunting. Further application of surgical procedures in the treatment of PCNSL is recommended with caution and strict patient selection criteria, and should be used in combination with radiotherapy and/or chemotherapy.

show abstract

MATILDE regimen followed by radiotherapy is an active strategy against primary CNS lymphomas

Cited by 83 publications

References 8 publications

Successful change of treatment strategy in elderly patients with primary central nervous system lymphoma by de-escalating induction and introducing temozolomide maintenance: results from a phase II study by The Nordic Lymphoma Group

Successful change of treatment strategy in elderly patients with primary central nervous system lymphoma by de-escalating induction and introducing temozolomide maintenance: results from a phase II study by The Nordic Lymphoma Group

Neuroendoscopic biopsy of ventricular tumors: a multicentric experience

Limited role of surgery in the management of primary central nervous system lymphoma (Review)

Contact Info

Product

Resources

About