Table 2 Summary of the recommendations
Management | Recommendations |
|---|---|
Biopsy and diagnosis | We suggest the histopathological specimens of PCNSL patients should be obtained as safely and comprehensively as possible by multimodal tomography-guided biopsy or minimally invasive surgery (2C) |
We recommend that corticosteroids should be withdrawn from, or not be administered to, patients with suspected PCNSL before biopsy, if the patient’s status so permits (1C) | |
We suggest that corticosteroids should be withdrawn from patients with suspected PVRL at least 2 weeks before biopsy, if the patient’s status permits (2D) | |
Staging and following-up evaluation | We recommend MRI (enhanced and DWI) for the diagnosis and evaluation of PCNSL patients (1B) |
We suggest that whole-body PET-CT be used to evaluate PCNSL patients at certain time points, such as the time of initial diagnosis or at relapse (2B) | |
We suggest that MMSE be used to assess cognitive function in the management of PCNSL patients (2B) | |
Induction therapy | We recommend that newly diagnosed PCNSL patients should be treated with a combined HD-MTX-based regimen, if the patient is fit for chemotherapy (1B). The combined therapeutics can be rituximab (2C), cytarabine (2B), temozolomide (2C) or other drugs which can cross the BBB (2C) |
We suggest that newly diagnosed PCNS-DLBCL patients can be treated with a rituximab-inclusive regimen at induction therapy (2C) | |
Consolidation therapy | Compared with non-reduced dose WBRT, we suggest that ASCT can be used as consolidation therapy for PCNSL patients who are fit for conditioning chemotherapy (2C) |
Refractory/relapsed | We suggest that refractory or relapsed PCNSL patients can be treated with ibrutinib with or without high-dose chemotherapy as re-induction therapy (2C) |
We suggest that stereotactic radiosurgery can be used for PCNSL patients with a limited recurrent lesion who were refractory to chemotherapy and have previously received WBRT (2D) | |
Intraocular involvement | We suggest that patients with suspected of PVRL should be diagnosed by vitreous biopsy (2D) |
We suggest that PVRL patients or PCNSL patients with concurrent VRL can be treated with combined systemic and local therapy (2C) |