原发性中枢神经系统淋巴瘤的前瞻性治疗研究  

Treatment of primary central nervous system lymphoma: a prospective study

作　　者：程岗[1] 王亚明[1] 董超[1] 张雷鸣[1] 于新[1] 尹丰[1] 赵明明[1] 赵虎林[1] 方丹东[1] 王鹏[1] 李海龙[1] 郭志峰[1] 李庆岗[1] 王洪伟[1] 贾博[1] 刘锐[1] 张剑宁[1] 

机构地区：[1]海军总医院神经外科,北京100048

出　　处：《中华神经外科疾病研究杂志》2016年第1期5-8,共4页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的通过前瞻性研究,寻找安全有效的原发性中枢神经系统淋巴瘤(PCNSL)治疗方法。方法 2014年2月至2015年2月,共收治年龄75岁以下的PCNSL病例38例,给予甲氨蝶呤+替莫唑胺方案治疗,使用或不使用利妥昔单抗(MT-R方案),观察此方案的临床疗效及安全性。结果按照影像学判断标准,38例患者中2周期后达到PR的患者共31例,SD 3例,PD 1例,死亡3例,有效率为81.58%。按照美国东部肿瘤协作组(ECOG)评分标准,共28例患者的ECOG评分较治疗前减少1分或评分为1分以下,有效率为73.68%。恶心、呕吐症状最常见,6例出现白细胞降低。死亡3例。结论 MT-R方案具有良好的安全性,临床效果满意,但是对于用药剂量及治疗周期仍需进行优化。Objective A safe and effective treatment protocol for primary central nervous system lymphoma （PCNSL） in a prospective study is discussed. Methods Thirty-eight patients with PCNSL under 75 years were included in the study admitted to the hospital from February 2014 to February 2015. The patients were treated by methotrexate and temozolomide, and rituximab was used in some patients （MT-R protocol）. Efficacy and safety of the protocol was investigated.Rzesults After 2 cycles of treatment, PR was got in 31 patients, SD was achieved in 3 patients, and PD in 1 patient. There were 3 death cases. The effective rate was 81.58%. According to Eastern Cooperative Oncology Group （ECOG） performance status, 28 patients got 1 score after the treatment or the score was improved. The effective rate was 83.68%. Nausea and vomiting was common. Leucopenia happened in 6 patients. There were 3 death cases. Conclusion MT-R is a safe and effective treatment protocol for PCNSL. Dosage and treatment method need to be improved.

关 键 词：原发性中枢神经系统淋巴瘤 甲氨蝶呤 替莫唑胺 利妥昔单抗 

分 类 号：R739.4[医药卫生—肿瘤]