摘要
目的 探讨原发于脑的多发性淋巴瘤诊治策略。方法 分析 1999年 9月～ 2 0 0 2年 6月收治 5例患者的诊治情况 ,均经病理证实为非霍奇金淋巴瘤 ,B细胞来源。所有病人均接受放、化疗综合治疗。结果 脑多发性淋巴瘤放射生物效应或放射敏感性不同。近期疗效良好。全组生存时间 8～ 4 8个月 ,1、3年生存率分别为 80 %和 2 5 %。其中 3例放疗 4 0～ 5 5Gy加 6周期化疗者分别生存 1～ 4年 ;另 2例放疗 6 0～ 75Gy加3～ 4周期化疗者分别生存 8～ 12个月。 4例治疗后 4～ 2 4个月复发 ,其中 2例出现脊髓侵犯。结论 脑多发性淋巴瘤易被误诊 ,三维立体定向穿刺活检 (定向活检 )可显著提高诊断效率。此病易复发 ,疗效不理想 ,伴脊髓侵犯者则更差。中等剂量放疗加足疗程化疗是有效的治疗方法 ,增加放射剂量未能改善肿瘤控制。放、化疗综合治疗可望提高疗效。
Objective To investigate the clinical tactics for diagnosis and treatment of primary cerebral multiple lymphoma (PCML). Methods Five patients with MRI and pathologically confirmed PCML were admitted from September, 1999 to June, 2002. The Tumor showed B lymphocyte origin. The patients received chemotherapy after radiotherapy. Results Radiation sensitivity of PCML was different. The tumors responded well to the treatment, but the overall survival time was only 8～48 months. The 1-and 3-year survival rates were 80% and 25%. 3 patients received radiotherapy dose for 40～55 Gy plus chemotherapy of 6 cycles and had survival time of 1～4 year, while 2 patients recieued 60～75 Gy plus 3～4 cycles chemotherapy, survived 8～12 months. During the follow up, 4 cases had tumor relapse at the original site and 2 of them were diagnosed as spinal invasion.Conclusion Diagnosis of PCML was difficult. 3-dimensional stereotatic biopsy can improve diagnostic efficiency. The disease relapses easily and the treatment outcome is disappointing. Patients accompanied with spinal invasion has poorer prognosis. Radiotherapy of moderate dose plus enough chemotherapy is effective. Radiotherapy dose escalation fails to give better control, while combined modelity therapy may improve the patients' survival.
出处
《海军总医院学报》
2004年第1期21-25,共5页
Journal of Naval General Hospital of PLA
关键词
脑
非霍奇金淋巴瘤
三维立体定向活检
放射治疗
化学治疗
综合治疗
Cerebral
Non-Hodgkin's lymphoma
3-dimensional stereotatic biopsy
Radiotherapy
Chemotherapy
Combined modality therapy
