原发性中枢神经系统淋巴瘤21例临床分析

Clinical analysis of 21 patients with primary central nervous system lymphoma

目的探讨原发性中枢神经系统淋巴瘤的治疗方法。方法对近5年笔者所在医院经手术或立体定向活检病理证实的21例原发性中枢神经系统淋巴瘤患者,予大剂量甲氨蝶呤化疗5～8周期及阿糖胞苷+地塞米松鞘内注射12～16次,后续放疗。结果 21例患者中位生存期(45.00±2.05)个月。预计5年生存率(29.2%±2.1%)。毒副作用以骨髓抑制(100%)及胃肠道反应(78%)多见,其次为肝肾功能损害、口腔炎及脱发等。毒副反应多数可耐受。结论大剂量甲氨蝶呤化疗及阿糖胞苷+地塞米松鞘内注射后续放疗治疗原发性中枢神经系统淋巴瘤效果满意。

Objective To explore a better therapeutic regimen for primary central nervous system malignant lymphoma. Methods The diagnosis was confirmed by pathology in all the subjects. 21 patients received high - dose methotrexate for 5 -8 chemotherapy cycles and cytarabine with dexamethasone 12 - 16 times for intrathecal injection. Radiotherapy was carried out following chemotherapy. Results The Median survival were （ 45.00 ± 2.05 ） months. The estimated 5 - year OS was （29.2% ± 2. 1% ）. The most common side effects were myelosuppression （100%） and gastrointestinal tract disorders （78%） , after those were liver and（or） kidney functions abnormality, stomatitis and alopecia. All the side effects were endurable. Conclusion Intravenous injection of high - dose methotrexate associating with intrathecal injection of cytarabine and dexamethasone followed by radiotherapy is a good remedy for primary central nervous system lympboma.