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Stereotactic Brachytherapy with Iodine-125 Seeds Plus Temozolomide Induced Complete and Durable Remission in a
Jian Zheng1, Chun Wang1, Fengqiang Liu1
1Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Background:
The optimal treatment of recurrent primary central nervous system lymphoma (PCNSL) has not yet been determined. We report a patient with recurrent PCNSL who has been successfully treated with stereotactic brachytherapy (SBT) with iodine-125 seeds plus temozolomide (TMZ).
Case Description:
A 51-year-old man who underwent left occipital lobe tumor resection 11 years earlier presented with a 1-month history of right hand weakness. Magnetic resonance imaging (MRI) revealed a recurrent PCNSL, which was confirmed by pathological examination. He was treated with SBT plus TMZ. At 1 month after surgery, a repeat MRI revealed nearly complete disappearance of the lesion. At 13.5 months postsurgery, the patient was neurologically intact except for right homonymous hemianopia, and follow-up MRI did not reveal a recurrent tumor.
Conclusions:
To our knowledge, this is the first case of recurrent PCNSL successfully treated with SBT plus TMZ. Further randomized studies are needed to confirm the therapeutic impact of this new method.
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