原发性中枢神经系统淋巴瘤诊断与治疗进展

Advances in the Diagnosis and Treatment of Primary Central Nervous System Lymphoma

原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL),是一类发生于中枢神经系统恶性非霍奇金淋巴瘤,尽管近年来恶性淋巴瘤的治疗迅速发展,但PCNSL的预后是各种类型淋巴瘤中最差的,5年生存率约20%～30%。放射治疗长期以来被作为PCNSL的标准方案,但是因为其较高的局部复发率和毒副作用限制放射治疗的作用。各种以大剂量甲氨蝶呤为基础新的治疗方案,改善了PCNSL的治疗效果,但是仍然需要更多临床试验的证据来确定最佳治疗方案。

Primary Central Nervous System Lymphoma (PCNSL) is an extranodal non-Hodgkin lymphoma (NHL) that arises from central nervous system. Even with the development of the NHL 's therapeutic strategies, PCNSL still has the worst prognosis,with five-year survival rate of 20%-30%. Radiotherapy has been regarded as the first-line treatment, but high rate of local recurrence and neurotoxicity limit the therapeutic beneficial. The development of regimen based on high-dose MTX leads to significant changes in the PCNSL treatment. Further new clinical trails are still needed to define the optimum therapeutic management.