原发中枢神经系统淋巴瘤治疗及预后分析

The Treatment and Prognostic Factors of 31 Cases with Primary Central Nervous System Lymphoma

目的:探讨原发中枢神经系统淋巴瘤(PCNSL)的有效治疗方法及预后因素。方法:分析总结31例PCNSL患者的临床特点、病理类型及不同治疗方案对生存期的影响。结果:发病年龄11-81岁,中位年龄52岁,年龄越大,预后越差。病理类型全系非何奇金淋巴瘤,B细胞型占90.91%,其中中心母细胞型占90.00%,T细胞型仅9.09%,T细胞及富T的B细胞型预后较差。生存时间5-42个月,中位生存时间15个月。全部手术切除病灶,术后采用不同治疗方案,其中位生存时间分别为:单独放疗8个月,单独化疗13个月,放疗联合化疗13个月,化疗或放疗联合鞘内给药均为19个月,比较单独放疗组与放疗联合化疗及鞘内给药组的生存时间有显著差异。结论:原发中枢神经系统淋巴瘤生存期短,其预后主要与发病年龄、病理类型及治疗方法有关,化疗或放疗联合鞘内给药为有效治疗方法。

Objective: To study the effective treatment and prognostic factors of primary central nervous system lymphoma (PCNSL). Methods: The relation between survival time and clinical features, pathological type and different treatments in 31 cases with PCNSL was studied. Results; The patients age at the diagnosis was 11-81 yearsold, the median age was 52 years, the survivial time for the aged patients was short. The pathological type of 31 cases were non-Hodgkin's lymphoma 90. 91%B cell type, 90. 00% was centroblastic cell and 9. 09% was T-cell type. The prognosis of T-cell type and T-cells are rich in B cell type PCNSL were poor. Turmors were removed by surgery in au patients and received different treatments after surgexy. The survivial time for radiotherapy, chemotherapy, radiotherapy combined with chem otherapy, chemotherapy or radiotherapy combined with intrathecal injection was 8, 13, 13, 19 months respectirely. There was a significant difference in the survival time between between radiotherapy, radiotherapy combined chemotherapy and intrathecal injection. Conclusions: PCNSL patients had short survivial time, the prognosis was related with the age at diagnosis, pathological type and different treatments, chemotherapy or radiotherapy combined with intrathecal injection were the effective treatment.