Primary Central Nervous System Lymphoma

Primary CNS Lymphoma (PCNSL) is a rare, aggressive variant of non-Hodgkin lymphoma (NHL) involving the central nervous system. Immunodeficiency is a risk factor. Expected 2-year survival varies from 20% to 80% depending on risk factors. Whole brain radiation was the standard treatment historically. With the evolving role of standard and high-dose chemotherapy, targeted therapy, and stem cell transplantation, radiation has been used less frequently. However, radiation remains an important component of treatment, and modern radiation approaches reduce the risk of previously known acute and long-term side effects. It is important to understand the current role of radiation in the management of PCNSL. This chapter will summarize important aspects of radiation planning and includes a case-based discussion.