Abstract

LEON GONZALEZ, Roberto A. et al. Primary brain lymphoma: Effectiveness and secondary effects of the oncospecific treatment. Rev cubana med [online]. 2006, vol.45, n.2, pp. 0-0. ISSN 1561-302X.

It has been stated that the effectiveness of chemotherapy for the treatment of primary central nervous system lymphoma (PCNSL) has not been proved; however, the intravenous or intrathecal treatment with methotrexate has been used and satisfactory results have been obtained. The case of a patient with diagnosis of PCNSL and an intraparenchymatous infiltration on the left temporoparietal region at the onset of the disease, and later on the homolateral pontocerebellar angle, is reported. Systemic and intrathecal oncospecific polychemotherapy and holocranial radiotherapy were applied. All the reported lesions disappeared, and a satisfactory evolution was observed, although this patient had severe late alterations of his higer psychical functions with progressive cognoscitive and behavorial disorders. Lesions such as cortical atrophy, leukoatrophy, dilated ventricular system, and hyperintensive areas in the white matter of the brain without tumoral recurrence were evidenced in the imaging study. The positive impact of chemotherapy on the treatment of primary brain lymphoma was verified, as well as the neurotoxicity in the central nervous system caused by the oncospecific treatment (radiotherapy and chemotherapy). It was considered that radiotherapy and combined therapy should be only used in relapses. It was recommended to conduct a comparative clinical study with periodical neuropsychological assessments to determine the posible neurotoxic effect caused by radiotherapy and chemotherapy. From the clinical and imaging point of view, the patient presented a neurotoxic atrophic leukoencephalopathy .

Keywords : Cognition; lymphoma; leucoencephalopathy; neurotoxicity; polychemotherapy; radiotherapy.