Evidence-based expert consensus on the management of primary central nervous system lymphoma in China

被引：0
作者：
Tong Chen
Yuanbo Liu
Yang Wang
Qing Chang
Jinsong Wu
Zhiliang Wang
Daoying Geng
Jin-Tai Yu
Yuan Li
Xiao-Qiu Li
Hong Chen
Dongxiao Zhuang
Jianyong Li
Bin Wang
Tao Jiang
Lanting Lyu
Yuqin Song
Xiaoguang Qiu
Wenbin Li
Song Lin
Xinghu Zhang
Dehong Lu
Junqiang Lei
Yaolong Chen
Ying Mao
机构：
[1] Fudan University,Department of Hematology, Institute of Medicine, Huashan Hospital
[2] Capital Medical University,Department of Hematology, Beijing Tiantan Hospital
[3] Fudan University,Department of Radiation Oncology, Huashan Hospital
[4] Huashan Hospital,National Center for Neurological Disorders
[5] Fudan University,Department of Ophthalmology, Eye and ENT Hospital
[6] Fudan University,Department of Neurosurgery, National Center for Neurological Disorders, Huashan Hospital
[7] Fudan University,Institute of Medicine
[8] Huashan Hospital,Department of Ophthalmology, Huashan Hospital
[9] Fudan University,Department of Radiology, Huashan Hospital
[10] Fudan University,Department of Neurology, Huashan Hospital
[11] Fudan University,Department of Pathology
[12] Fudan University,Department of Pathology, Huashan Hospital
[13] Fudan University Shanghai Cancer Center,Department of Hematology
[14] Fudan University,Department of Pharmacy, Huashan Hospital
[15] The First Affiliated Hospital of Nanjing Medical University,Department of Neurosurgery, Beijing Neurosurgical Institute, Beijing Tiantan Hospital
[16] Jiangsu Province Hospital,School of Public Administration and Policy, Health Technology Assessment and Policy Evaluation Group
[17] Fudan University,Department of Lymphoma
[18] Capital Medical University,Department of Radiation Oncology, Beijing Tiantan Hospital
[19] Renmin University of China,Department of Neuro
[20] Peking University Cancer Hospital and Institute,Oncolgoy, Cancer Center, National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital
[21] Capital Medical University,Department of Neurology, Neuroimmunology and Neuroinfection Center, Beijing Tiantan Hospital
[22] Capital Medical University,Department of Pathology, Xuanwu Hospital
[23] Capital Medical University,Department of Radiology
[24] Capital Medical University,Research Unit of Evidence
[25] The First Hospital of Lanzhou University,Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical Sciences
[26] Lanzhou University,WHO Collaborating Center for Guideline Implementation and Knowledge Translation
[27] Lanzhou University,undefined
[28] Lanzhou University GRADE Center,undefined
来源：
Journal of Hematology & Oncology | / 15卷
关键词：
Consensus; Primary central nervous system lymphoma; Management; China;
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摘要：
Primary central nervous system lymphoma (PCNSL) is a type of central nervous system restricted non-Hodgkin lymphoma, whose histopathological diagnosis is majorly large B cell lymphoma. To provide specific, evidence-based recommendations for medical professionals and to promote more standardized, effective and safe treatment for patients with PCNSL, a panel of experts from the Chinese Neurosurgical Society of the Chinese Medical Association and the Society of Hematological Malignancies of the Chinese Anti-Cancer Association jointly developed an evidence-based consensus. After comprehensively searching literature and conducting systematic reviews, two rounds of Delphi were conducted to reach consensus on the recommendations as follows: The histopathological specimens of PCNSL patients should be obtained as safely and comprehensively as possible by multimodal tomography-guided biopsy or minimally invasive surgery. Corticosteroids should be withdrawn from, or not be administered to, patients with suspected PCNSL before biopsy if the patient’s status permits. MRI (enhanced and DWI) should be performed for diagnosing and evaluating PCNSL patients where whole-body PET-CT be used at necessary time points. Mini-mental status examination can be used to assess cognitive function in the clinical management. Newly diagnosed PCNSL patients should be treated with combined high-dose methotrexate-based regimen and can be treated with a rituximab-inclusive regimen at induction therapy. Autologous stem cell transplantation can be used as a consolidation therapy. Refractory or relapsed PCNSL patients can be treated with ibrutinib with or without high-dose chemotherapy as re-induction therapy. Stereotactic radiosurgery can be used for PCNSL patients with a limited recurrent lesion who were refractory to chemotherapy and have previously received whole-brain radiotherapy. Patients with suspected primary vitreoretinal lymphoma (PVRL) should be diagnosed by vitreous biopsy. PVRL or PCNSL patients with concurrent VRL can be treated with combined systemic and local therapy.
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