Management of refractory or relapsed primary central nervous system lymphoma (Review)

Primary central nervous system lymphoma (PCNSL) is a non-Hodgkin's lymphoma arising in the central nervous system. Combined methotrexate-based chemoradiotherapy is the standard treatment for PCNSL, resulting in a median overall survival of 25-51 months. Failure of first-line treatment has been reported in most patients with PCNSL. Salvage therapy improves outcome; however, since many different treatments have been applied, conclusions cannot be drawn regarding an optimal treatment schedule. This review analyzes the efficacy of different salvage therapies that have been reported in the literature. These well-designed, randomized trials may help elucidate issues such as the best chemotherapy regimen for second-line treatment.