[Response to chemotherapy in cerebral primary lymphoma]

Primary central nervous system lymphomas (PCNSL) are infrequent, rapidly growing and generally limited to the central nervous system (CNS). In recent years there has been a threefold increase in cases occurring in immunocompetent individuals. Conventional treatment with corticosteroids and radiotherapy is effective, but over 80% relapse in less than a year. Chemotherapy has significantly improved the results of treatment.

We present a case of PCNSL in an immunocompetent patient which was resistant to radiotherapy (RT). There was progression of the lymphoma three months after irradiation, and later multicentric progression one month after radiosurgery. The patient had complete radiological remission after systemic chemotherapy. The clinical improvement was obvious, since before chemotherapy was started the patient was in coma and had episodes of apnea. The therapeutic response obtained was consolidated by intensive chemotherapy and hemopoietic support. The condition is still in remission three years after completion of this treatment.

There are no publications about the results of combined radiotherapy and chemotherapy in series of patients with PCNSL, since there are relatively few patients and many methods of treatment are tried.