大剂量MTX联合化疗及放射治疗原发性中枢神经系统淋巴瘤  

Treatment of Primary Central Nervous System Lymphoma by Combination of High Dose Methotrexate with Several Chemotherapic Drugs Followed by Irradiation

作　　者：钟璐[1] 韩洁英[1] 陈芳源[1] 钟华[1] 邵念贤[1] 欧阳仁荣[1] 

机构地区：[1]上海第二医科大学仁济医院血液科,上海200001

出　　处：《上海第二医科大学学报》2003年第1期51-53,共3页Acta Universitatis Medicinalis Secondae Shanghai

摘　　要：目的 探讨大剂量MTX联合多药化疗方案治疗原发性下丘脑恶性淋巴瘤的疗效。 方法1例经临床及实验室检查、CT、MRI以及活检确诊为鞍区“B”淋巴瘤的患者,选择大剂量MTX、甲基苄肼、VCR、DX联合化疗,每2周1次,共3次,同步行鞘内注射化疗。化疗结束后行头颅放射治疗。以后每3月行原化疗方案巩固1次。 结果化疗1疗程后,患者头痛症状完全消失,病灶明显缩小;3疗程后,患者记忆力完全恢复,尿量明显减少,血象及脑脊液检查正常,MRI示病灶完全消失。随访至今未见新、老病灶出现。 结论多种能渗透血脑屏障化疗药物的联合应用,尤其加大MTX剂量以及联合放疗,能显著提高原发性中枢神经系统淋巴瘤的治疗效果。Objective To evaluate the efficacy of high dose methotrexate ( MTX ) combinated with several chemotherapic drugs for treatment of primary hypothalamus lymphoma. Methods One Patient with of lymphoma in the sella turcica B, diagnosed by clinical and laboratory features, CT scanning, MR imaging and biopsy was treated with combination of high dose MTX , Matulane, VCR , DX , intrathecal-ly biweekly for three courses, to be followed by cranial irradiation. The patient received this consolidation chemotherapy formula every three months. Results The symptom of headache disappeared, the tumor volume was reduced obviously after one course of chemotherapy, the ability of memory recovered, and the quantity of urine was also reduced. The data of blood and cerebrospinal fluid (CSF) were normal. The tumor disappeared completely on MR study after three courses. Up to now, the mass had not been identified found at all. Conclusion Combination of high dose methotrexate with several chemotherapic drugs, which are able to penetraete the blood-brain barrier, can be used more effetively for primary central nervous system lymphoma .

关 键 词：甲氨蝶呤 MTX 化疗 放射 治疗 原发性中枢神经系统淋巴瘤 

分 类 号：R739.4[医药卫生—肿瘤]