Study to evaluate the feasibility of response adapted whole brain radiotherapy after methotrexate based chemotherapy in patients of newly diagnosed primary CNS lymphoma

The primary objective of the study is toevaluate the feasibility of response adapted whole brain radiation therapy after methotrexate based chemotherapy in immunocompetent patients of newly diagnosed primary central nervous system (CNS) lymphoma. The secondary objectives are

1.      To assess Epstein-Barr Virus (EBV) positivity and molecular subtype of lymphoma and their correlation with treatment outcome

2. To assess the toxicity profile, neurocognitive effects of  treatment and serial changes in quality of life in  patients of primary central nervous system lymphoma

The reduced dose whole brain radiotherapy in patients with complete response after methotrexate based polychemotherapy has yielded excellent outcomes in foreign studies. This kind of study has not been conducted in Indian context. This will benefit the complete responders of chemotherapy by reducing treatment related neurotoxicity thus improve quality of life in the patients of Primary CNS lymphoma without compromising disease control. We are also correlating EBV positivity, molecular subtyping with treatment outcomes which may open further doors of research for personalised treatment and novel therapies. We will be doing neurocognitive assessment using the neuropsychological test battery designed for Indian context according to international recommendations so it will effectively assess the treatment related neurotoxicity in Indian patients who are educationally, socioeconomically and linguistically different from Western population.