原发性中枢神经系统淋巴瘤的放射治疗进展  

Progress on radiotherapy of primary central nervous system lymphoma

作　　者：李盼盼 张卓[1] Li Panpan;Zhang Zhuo(Department of Radiation Oncology,the Second Affiliated Hospital of Dalian Medical University,Dalian 116027,China)

机构地区：[1]大连医科大学附属第二医院肿瘤放疗科,大连116027

出　　处：《中华放射肿瘤学杂志》2022年第5期473-477,共5页Chinese Journal of Radiation Oncology

摘　　要：原发性中枢神经系统淋巴瘤(PCNSL)是指发生在脑、脊髓、脑膜或眼的罕见侵袭型非霍奇金淋巴瘤,以弥漫大B细胞淋巴瘤占绝大多数,其中又以Non-GCB亚型多见。未经治疗的患者中位生存期仅为3个月,单纯的手术切除肿瘤并没有明显的生存获益。早期单独使用全脑放疗(WBRT),缓解率高,但持续时间短,且延迟性神经系统不良反应是一个重要的并发症,尤其对于老年患者。后期研究发现以大剂量甲氨蝶呤为基础的化疗联合WBRT显著改善了疾病的预后;但联合治疗增加了神经系统不良反应风险,这种策略受到了质疑。近年来,减剂量全脑放射治疗和自体造血干细胞移植逐渐取代了以往标准剂量的WBRT。本文就PCNSL的放射治疗进展作一综述。Primary central nervous system lymphoma(PCNSL)is a rare aggressive non-Hodgkin's lymphoma that occurs in the brain,spinal cord,meninges or eyes.Diffuse large B-cell lymphoma accounts for the vast majority,of which non-GCB subtype is more common.The median survival time of untreated patients is only 3 months.Surgical removal of the tumor alone has no obvious survival benefit.Early single use of whole brain radiation therapy(WBRT)yields a high remission rate,but the duration is short,and delayed neurotoxicity is an important complication,especially for elderly patients.Subsequent studies found that high-dose methotrexate-based chemotherapy combined with WBRT significantly improved the prognosis of this disease.However,combination therapy increases the risk of neurotoxicity,and this strategy has been questioned.In recent years,reduced-dose WBRT and autologous hematopoietic stem cell transplantation have gradually replaced the previous standard-dose WBRT.This article reviews the progress on the radiotherapy for PCNSL.

关 键 词：原发性中枢神经系统淋巴瘤 全脑放疗 神经毒性 

分 类 号：R739.4[医药卫生—肿瘤]