34例原发性中枢神经系统恶性淋巴瘤临床分析

目的:分析免疫功能正常的中国人原发性中枢神经系统淋巴瘤(PCNSL)的临床资料,探讨PCNSL的临床特征,评价大剂量甲氨蝶呤(HD-MTX)加全脑放疗(WBRT)治疗PCNSL的疗效。方法:回顾性分析34例经病理证实的PCNSL患者的临床资料以及治疗效果,Kaplan-Meier法分析患者生存期。结果:34例PCNSL患者中B细胞淋巴瘤31例(91.2%),T细胞淋巴瘤3例(8.8%);所有患者治疗后评价完全缓解率(CR)41.2%,2年生存率60.2%;病理类型和是否接受HD-MTX加放疗是影响PCNSL生存期的主要原因(P<0.05)。结论:PCNSL以颅内高压为主要表现,B细胞亚型占绝对优势,具有独特的预后因素,HD-MTX联合放疗是PCNSL有效的治疗方法。

Clinical Analysis of 34 Patients with Primary Central Nervous System Lymphoma

Objective:To investigate the clinical features of primary central nervous system lymphoma(PCNSL),evaluate the efficacy of high-dose methotrexate(MTX)-based chemotherapy combining with whole brain radiation therapy(WBRT)for immunocompetent Chinese patients with PCNSL.Method:Clinical data of 34 patients that were pathologically diagnosed with PCNSL was analyzed retrospectively,and Kaplan-Meier method was used to calculate survival time.Result:Among 34 PCNSL patients,31(91.2%)were diagnosed with B-cell lymphoma,3(8.8%)T-cell lymphoma.The complete remission rate of treatment was 41.2%,and the 2-year survival rate was 60.2%.The overall survival time showed statistic correlation with tumor pathological type and the type of treatment patient received.Conclusion:The major clinical symptom of PCNSL is intracranial hypertension and it is considered as an important factor that affects the disease progression and prognosis.B-cell lymphoma is the predominant subtype of PCNSL and combination of High-dose MTX-based chemotherapy with whole brain irradiation treatment is a more efficient approach.