In contrast, radiation therapy has become the standard treatment, with doses of up to 45 Gy using standard fractionation. The addition of spinal axis radiation does not affect survival because it does not prevent cerebral relapse. These favorable results may be due to selection bias for patients of younger age and better performance status. The median survival for the whole group was only 41.7 weeks, but for patients 60 years of age or younger, the median survival was 47.4 months. Severe cognitive deficits are reported with these intensive therapies due to iatrogenic leukoencephalopathy.
Glucocorticoids can also produce substantial but short-lived remissions.
Steroid efficacy may complicate the diagnostic evaluation by obscuring the histologic findings. Consequently, most patients die of opportunistic infections irrespective of therapy for the lymphoma. Nelson DF, Martz KL, Bonner H, et al. Gabbai AA, Hochberg FH, Linggood RM, et al. Blay JY, Bouhour D, Carrie C, et al.