以替尼泊苷为主的化疗方案治疗原发性中枢神经系统淋巴瘤16例  

Teniposide-based regimen for 16 patients with primary central nervous system lymphoma

作　　者：仲凯励[1] 肖秀斌[1] 达永[1] 陈喜林[1] 刘静[1] 张伟京[1] 苏航[1] 

机构地区：[1]军事医学科学院附属医院解放军第三〇七医院淋巴头颈肿瘤科,北京100071

出　　处：《肿瘤研究与临床》2015年第7期445-448,共4页Cancer Research and Clinic

摘　　要：目的：研究以替尼泊苷为主的化疗方案对原发性中枢神经系统淋巴瘤（PCNSL）的疗效及患者不良反应。方法回顾性分析2011年3月至2013年7月明确诊断并治疗的16例PCNSL患者的临床表现、疗效及不良反应。结果16例PCNSL患者均为弥漫大B细胞淋巴瘤，接受以替尼泊苷为主的方案化疗，9例患者加用利妥昔单抗。16例中10例获得完全缓解，4例获得部分缓解，总反应率为87.5%（14／16）。中位随访13.5个月，2年无进展生存率29.9%，总生存率66.7%。患者主要不良反应为粒细胞减少，其中3级减少4例（25%），4级减少仅1例。有1例治疗相关性死亡。结论以替尼泊苷为主的化疗方案治疗原发性中枢神经系统弥漫大B细胞淋巴瘤总反应率较高，远期生存率高于常规甲氨蝶呤方案，患者不良反应较轻，耐受性良好。Objective To investigate the therapeutic effect and adverse effects of the teniposide-based regimen in patients with primary central nervous system lymphoma （PCNSL）. Methods Between March 2011 and July 2013, 16 patients with PCNSL were diagnosed and treated. The clinical characteristics, diagnosis,therapy, results and adverse effects were analyzed. Results Totally 16 patients were enrolled and diagnosed as primary central nervous system diffuse large B-cell lymphoma. All patients received teniposide-based regimen chemotherapy and 9 patients received teniposide plus rituximab. The overall response rate was 87.5 % （14/16）, including 10 cases of CR and 4 cases of PR. With a median follow-up of 13.5 months, the progression-free survival （PFS） and overall survival （OS） rates of 2 years were 29.9 % and 66.7 %, respectively. The mainly hematological adverse events were neutropenia, including grade 3 in 4 cases （25 %） and grade 4 just in one case. There was one case of treatment related death. Conclusions The response rate of teniposide-based regimen for PCNSL is promising. The 2 year PFS and OS rates are even higher than results of traditional high-dose methotrexate regimen. The teniposide-based regimen is well tolerated, and the adverse events are acceptable.

关 键 词：淋巴瘤 中枢神经系统 替尼泊苷 

分 类 号：R739.4[医药卫生—肿瘤]