Abstract Background Frontline intensification (including consolidative whole‐brain radiotherapy or high‐dose chemotherapy with autologous stem‐cell transplantation after induction therapy) has been proposed to treat primary central nervous system lymphoma (PCNSL). However, no prospective randomized trials have answered whether frontline intensification can offer a survival benefit to PCNSL patients. We aim to clarify the outcomes and survival influence of frontline intensification on real‐world patients with different risk‐stratified PCNSLs. Methods Between January 2003 and December 2016, 110 PCNSL adults were retrospectively included, and 76 patients achieved at least PR after induction therapy, including 38 patients who received frontline intensification. The median follow‐up with the 31 survivors was 7.52 years. Results Of the 38 induction‐completed patients who had not received frontline intensification, 95% achieved post–induction therapy CR/CRu; however, all inevitably recurred. In the 38 who received frontline intensification, CR/CRu improved from 45% (pre‐frontline intensification) to 84% (post‐frontline intensification), and they achieved significantly better PFS (non‐reach vs. 522 days, p
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