Intrathecal Chemotherapy

Although the experience from systemic lymphoma and leukemia clearly supports the use of intrathecal chemotherapy to prevent or treat leptomeningeal disease, its role in the treatment of PCNSL remains controversial. Most therapeutic regimens for PCNSL rely on high-dose MTX and high-dose ARA-C, both of which, when administered as a rapid infusion, can achieve tumoricidal CSF levels, thus obviating the need for IT chemotherapy [41,46]. Furthermore, at

least two retrospective studies have failed to demonstrate any advantage in terms of disease control or survival for patients treated with intrathecal chemotherapy [41,46,47].

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