摘要
目的:分析原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)的其临床特点、治疗和预后。方法:患者收集31例PCNSL患者的临床资料,回顾性分析其临床特点,采用Kaplan-Meier法和Cox比例风险模型分析生存和预后。结果:患者发病中位年龄52岁,男女比例近1∶1;首发症状以头痛、头晕、肢体麻木为多见。常见发病部位为顶、额、颞叶和胼胝体;行手术切除25例,手术活检6例,其中立体定向活检术3例;病理类型均为弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL),生发中心型6例,非生发中心型25例。综合治疗为化疗后序贯放疗,共计17例,另单纯化疗3例,单纯放疗8例,支持治疗3例。患者中位随访24个月。1年、3年和5年OS分别为80.6%、55.1%和36.4%。综合治疗组OS时间显著长于单纯放疗组,是否接受利妥昔单抗治疗对OS无显著影响。预后分析显示,ECOG PS≥2分和血清LDH异常为不良预后因素。结论:PCNSL临床表现复杂多样,目前尚无最佳治疗方案,综合治疗组患者中位OS时间显著长于单纯放疗组。发病时ECOG PS≥2分和血清LDH异常为不良预后因素。
Objective:To investigate the clinical characteristics,therapeutic outcomes and prognostic factors of primary central nervous system lymphoma(PCNSL).Methods:Clinical records of 31 cases of PCNSL were collected,the clinical charactenstics were analyzed retrospectively.Survival curves were estimated using Kaplan-Meier survival methodology and statistical significance of continuous variables was assessed via the Cox proportional hazard model.Results:The median age was 52 years,with a ratio of male to female 1:1.Headache/dizzy/limb numbness were the most common presentation and the lesions of PCNSL were primarily located at the frontal,parietal,temporal lobes and corpus callosum.All the cases were pathologically diffuse large B cell lymphoma(DLBCL),6 cases were the type of germinal center(GC) and 25 cases of non-GC type,after craniotomy operation and biopsy.Among 31 cases,17 patients accepted the combined treatment,3 patients underwent simple chemotherapy,8 patients received simple radiotherapy,the other patients accepted support therapy.The median follow-up for surviving patients was 24 months.The 1-,3-,and 5-year survival rates were 80.6%,55.1%,and 36.4%Respectively.The median overall survival time in the combined treatment group was significantly longer than that in simply radiotherapy.There was no significant difference in OS between the groups with and without rituximab.ECOG PS ≥ 2 and elevated serum LDH predicted inferior survival.Conclusion:The clinical manifectation of PCNSL is various and complicated,and for the time being there is no optimal treatment scheme.The overall survival time of the combined treatment is longer than that in simply radiotherapy.ECOG PS ≥2 and elevated serum LDH often are poor prognostic factors.
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2016年第4期1061-1065,共5页
Journal of Experimental Hematology
