How will you manage a patient with symptomatic secondary CNS involvement from DLBCL not eligible for HD-MTX?  

Patients with secondary CNS lymphoma have historically had a very poor prognosis. Depending upon circumstances, many patients today are treated with a chemotherapy regimen that penetrates the blood-brain barrier (e.g., MATRix). If the patient responds favorably and is fit, high-dose chemotherapy fol...

This is a common scenario. Given that the patient is not eligible for intensive treatment there are two options: Try an alternative systemic treatment first and deliver RT as consolidation or upon further progression. Clinical trials/novel systemic concepts could be pursued. The volume highly dep...