Response to chemotherapy in cerebral primary lymphoma
Introduction. 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. Clinical case. 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. Conclusions. 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
Caso clínico Presentamos un caso de LPSNC en un paciente inmunocompetente, resistente a radioterapia (RT): progresión a tres meses de la irradiación y posterior progresión multicéntrica al mes de la radiocirugía. El paciente alcanza remisión completa radiológica con quimioterapia (QT) sistémica. La mejoría clínica fue evidente ya que antes de iniciar la QT el paciente se encontraba en coma y con fases de apnea. La respuesta alcanzada se consolida con QT intensiva con soporte hematopoyético. El paciente continúa en remisión tres años después de haber finalizado los tratamientos.
Conclusión No se han descrito series sobre resultados de RT y QT combinados en LPSNC debido a la escasa casuística y a la heterogeneidad de los tratamientos aplicados a estos pacientes
