. 2021 Jun 30;33(3):289–301. doi: 10.21147/j.issn.1000-9604.2021.03.01

Table 11. Treatment strategies for newly-diagnosed primary central nervous system lymphoma.

Stratification	Therapy section	Category I recommendations	Category II recommendation
, high-dose methotrexate should be infused with 4−6 h; , intra-CSF chemotherapy agents include: methotrexate, cytarabine and dexamethasone; **, long-term neurotoxicity of WBRT should be paid attention, especially in patients elder than 60 years. CSF, cerebrospinal fluid; MRI, magnetic resonance imaging; WBRT, whole brain radiotherapy.
Fit patients who can tolerate systemic chemotherapy	Induction	High-dose methotrexate-based regimen (Level 1 evidence)*	If CSF positive or spinal MRI positive, consider intra-CSF chemotherapy** consider clinical trials
	Consolidation	For patients achieved complete remission: High-dose chemotherapy (thiotepa-based regimen) with stem cell rescue (Level 1 evidence) High-dose cytarabine ± Etoposide (Level 2A evidence) Low-dose WBRT (Level 2A evidence)
	Maintenance		Low-dose lenalidomide or temozolomide (Level 2B evidence)
Unfit patients who cannot tolerate systemic chemotherapy	Induction	WBRT (Level 1 evidence) Methotrexate + temozolomide
Unfit patients who cannot tolerate systemic chemotherapy	Maintenance		Lenalidomide or temozolomide (Level 2B evidence)