原发中枢神经系统淋巴瘤临床特点与疗效:40例分析  

A Prognosis Analysis of 40 Cases of Primary Central Nervous System Lymphoma

作　　者：张冠华[1,2] 张湘衡[1,2] 杨群英[1,2] 赛克[1,2] 蒋小兵[1,2] 王振宁[1,2] 陈忠平[1,2] 牟永告[1,2] 

机构地区：[1]华南肿瘤学国家重点实验室,广东广州510060 [2]中山大学肿瘤防治中心神经外科/神经肿瘤科,广东广州510060

出　　处：《中国神经肿瘤杂志》2011年第1期21-25,共5页Chinese Journal of Neuro-Oncology

摘　　要：背景与目的:原发中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)近年来在免疫功能正常的人群中发病率有所上升。本研究的目的是探讨PCNSL的临床特征、治疗及预后。方法:回顾性分析经病理证实的40例PCNSL的临床资料。结果:40例患者中24例(60.0%)主要表现为颅内高压;21例(52.5%)单发病灶;28例(70.0%)为弥漫大B细胞淋巴瘤。12例(30.0%)手术全切肿瘤,中位KPS评分70;14例(35.0%)接受HD-MTX为主的化疗加全脑放疗;19例(47.5%)接受鞘内化疗。40例患者Kaplan-Meier分析总中位生存时间为26个月,2年生存率65.2%;HD-MTX联合全脑放疗组患者完全缓解率73.3%,中位生存时间38.5个月,2年生存率80.6%。结论:PCNSL患者临床表现主要为颅内压增高,单发病灶多见,B细胞亚型多见,HD-MTX联合适当剂量的全脑放射治疗可延长生存期,年龄、术后KPS评分影响预后。BACKGROUND OBJECTIVE： In recent years,the incidence of primary central nervous system lymphoma（PCNSL） increases in the immunocompetent patients.The purpose of this study is to explore the clinical characteristics,treatment and the prognosis of PCNSL.METHODS： Forty pathology-confirmed PCNSL cases were analyzed retrospectively.RESULTS： Of the 40 patients,24（60.0%） had increased cranial pressure as the major symptom.Twenty-one（52.5%） had single tumor location.Twenty-eight（70.0%） had diffuse large B-cell lymphoma.Twelve（30.0%）cases had total resection.The median Karnofsky performance score（KPS） was 70.Fourteen（35.0%） received HD-MTX-based chemotherapy in combination with whole brain radiotherapy（WBRT）.Nineteen（47.5%） received intrathecal chemotherapy.Kaplan-Meier analysis showed that the median overall survival（OS） was 26 months.The 2-year survival was 57.5%.The complete response（CR） rate of HD-MTX combined with radiotherapy was 73.3%,with an median survival time of 38.5 months and a 2-year survival of 80.6%.CONCLUSIONS： HD-MTX combined with radiotherapy can improve the clinical outcome of PCNSL.Age and KPS are prognostic factors for PCNSL patients.

关 键 词：中枢神经系统淋巴瘤 化疗 放疗 预后 

分 类 号：R739.41[医药卫生—肿瘤]