经Ommaya囊注射甲氨喋呤治疗原发颅内弥漫大B细胞淋巴瘤临床研究

目的观察经Ommaya囊注射甲氨喋呤治疗原发颅内弥漫大B细胞淋巴瘤的安全性及有效性。方法回顾性分析2011年7月至2013年12月收治的22例经Ommaya囊注射甲氨喋呤治疗原发颅内弥漫大B细胞淋巴瘤患者的临床资料。所有患者经手术或活检,病理确诊为弥漫大B细胞淋巴瘤,随后经全身CT检查明确身体其他部位无淋巴瘤侵犯,术中或术后全部患者均行Ommaya囊置入术,术后给予患者Ommaya囊内注入甲氨喋呤(12 mg)+地塞米松(5 mg),共注射6次(1次/周)。结果治疗后总有效率达100%,其中完全缓解9例(40.9%),部分缓解13例(50.1%),顺利接受全身化疗21例。结论经Ommaya囊注射甲氨喋呤治疗原发颅内弥漫大B细胞淋巴瘤是安全有效的。

The clinical research of injection of methotrexate through Ommaya reservoir for therapy of primary intracranial diffuse large B-cell lymphoma

Objective To observe the security and effectiveness of injection methotrexate through Ommaya reservoir for the therapy of primary intracranial diffuse large B-cell lymphoma. Methods A retrospective analysis was performed in 22 cases who received the injection of methotrexate through Ommaya reservoir to therapy primary intracranial diffuse large B-cell lymphoma. All patients were confirmed primary intracranial diffuse large B-cell lymphoma by pathologic diagnosis,whole body CT after operation or biopsy. Later,Ommaya reservoir were placed into patients＇ ventricle and injected methotrexate（ MTX） 12 mg ＋ dexamethasone（ DXM） 5 mg through Ommaya reservoir once a week. This treatment were continued for total six weeks. Results All patients get complete response（ CR） and partial response（ PR）. Nine（ 40. 9%） of twenty two patients get CR and thirteen（ 50. 1%） of twenty two patients get PR. Twenty one of twenty two patients accepted chemotherapy. Conclusion The injection of methotrexate through Ommaya reservoir during the therapy of primary intracranial diffuse large B-cell lymphoma is safe and effective.