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Evidence-based expert consensus on the management of primary central nervous system lymphoma in China

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机构： [1]Department of Hematology, Institute of Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China. [2]Department of Hematology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China. [3]Department of Radiation Oncology, Huashan Hospital, Fudan University, Shanghai 201107, China [4]National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai 200040, China [5]Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai 200031, China. [6]Department of Neurosurgery, National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai 200040, China. [7]Institute of Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China. [8]Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai 200040, China. [9]Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, China. [10]Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China. [11]Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032, China. [12]Department of Pathology, Huashan Hospital, Fudan University, Shanghai 200040, China. [13]Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China. [14]Department of Pharmacy, Huashan Hospital, Fudan University, Shanghai 200040, China. [15]Department of Neurosurgery, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China. [16]School of Public Administration and Policy, Health Technology Assessment and Policy Evaluation Group, Renmin University of China, Beijing 100872, China. [17]Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing 100142, China. [18]Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China. [19]Department of Neuro‑Oncolgoy, Cancer Center, National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China. [20]Department of Neurology, Neuroimmunology and Neuroinfection Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China. [21]Department of Pathology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China. [22]Department of Radiology, The First Hospital of Lanzhou University, Lanzhou 730000, China. [23]Research Unit of Evidence‑Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China. [24]WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou 730000, China. [25]Lanzhou University GRADE Center, Lanzhou 730000, China.

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Primary central nervous system lymphoma (PCNSL) is a type of central nervous system restricted non-Hodgkin lymphoma, whose histopathological diagnosis is majorly large B cell lymphoma. To provide specific, evidence-based recommendations for medical professionals and to promote more standardized, effective and safe treatment for patients with PCNSL, a panel of experts from the Chinese Neurosurgical Society of the Chinese Medical Association and the Society of Hematological Malignancies of the Chinese Anti-Cancer Association jointly developed an evidence-based consensus. After comprehensively searching literature and conducting systematic reviews, two rounds of Delphi were conducted to reach consensus on the recommendations as follows: The histopathological specimens of PCNSL patients should be obtained as safely and comprehensively as possible by multimodal tomography-guided biopsy or minimally invasive surgery. Corticosteroids should be withdrawn from, or not be administered to, patients with suspected PCNSL before biopsy if the patient's status permits. MRI (enhanced and DWI) should be performed for diagnosing and evaluating PCNSL patients where whole-body PET-CT be used at necessary time points. Mini-mental status examination can be used to assess cognitive function in the clinical management. Newly diagnosed PCNSL patients should be treated with combined high-dose methotrexate-based regimen and can be treated with a rituximab-inclusive regimen at induction therapy. Autologous stem cell transplantation can be used as a consolidation therapy. Refractory or relapsed PCNSL patients can be treated with ibrutinib with or without high-dose chemotherapy as re-induction therapy. Stereotactic radiosurgery can be used for PCNSL patients with a limited recurrent lesion who were refractory to chemotherapy and have previously received whole-brain radiotherapy. Patients with suspected primary vitreoretinal lymphoma (PVRL) should be diagnosed by vitreous biopsy. PVRL or PCNSL patients with concurrent VRL can be treated with combined systemic and local therapy.© 2022. The Author(s).

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出版当年[2021]版：

大类 | 1 区

医学

小类 | 1 区肿瘤学 1 区血液学

最新[2023]版：

大类 | 1 区

医学

小类 | 1 区血液学 1 区肿瘤学

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出版当年[2020]版：

Q1 HEMATOLOGY Q1 ONCOLOGY

最新[2023]版：

Q1 HEMATOLOGY Q1 ONCOLOGY

影响因子： 29.9 最新[2023版] 27.1 最新五年平均 17.388 出版当年[2020版] 12.642 出版当年五年平均 11.059 出版前一年[2019版] 23.168 出版后一年[2021版]

第一作者：

第一作者机构： [1]Department of Hematology, Institute of Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China.

通讯作者：

通讯机构： [6]Department of Neurosurgery, National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai 200040, China. [7]Institute of Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China. [23]Research Unit of Evidence‑Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China. [24]WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou 730000, China. [25]Lanzhou University GRADE Center, Lanzhou 730000, China.

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