利妥昔单克隆抗体加甲氨蝶呤对原发性中枢神经系统淋巴瘤的临床效果

Clinical effect of rituximab monoclonal antibody plus methotrexate on primary central nervous system lymphoma

目的探讨利妥昔单克隆抗体加甲氨蝶呤对原发性中枢神经系统淋巴瘤的治疗效果。方法选择2014年1月至2016年2月在该院进行治疗的原发性中枢神经系统淋巴瘤患者54例,按照随机数字法分为对照组和观察组,每组27例。对照组患者采用大剂量甲氨蝶呤联合全脑放疗的方案,观察组患者在对照组治疗方案基础上使用利妥昔单克隆抗体,对治疗效果进行比较。结果观察组患者的治疗有效率高于对照组,差异有统计学意义(χ~2=6.033,P<0.05)。两组患者的各项不良反应比较,只有呼吸道感染一项为观察组高于对照组,差异有统计学意义(P<0.05),其余不良反应差异均无统计学意义(P>0.05)。观察组患者生活质量优于对照组,差异有统计学意义(Z=2.895,P<0.05)。观察组患者的1年生存率、3年生存率和生存时间均优于对照组患者,差异有统计学意义(P<0.05)。结论采用利妥昔单克隆抗体与大剂量甲氨蝶呤对原发性中枢神经系统淋巴瘤患者进行治疗,可以提高治疗有效率,提高患者生活质量和生存率,值得在临床范围内进行推广。

Objective To investigate the clinical effect of rituximab monoclonal antibody plus methotrexate on primary central nervous system lymphoma.Methods Fifty-four cases of primary central nervous system lymphoma in this hospital from January 2014 to February 2016 were selected and divided into the control group and observation group according to the random number method,27 cases in each group.The control group adopted the scheme of high-dose methotrexate combined with whole brain radiotherapy,while on this basis the observation group used rituximab monoclonal antibody.Then the curative effects were compared.Results The effective rate of the observation group was higher than that of the control group,the difference was statistically significant(χ2=6.033,P<0.05).In the comparison of the adverse reactions between the two groups,only one item of respiratory tract infection in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05),the difference of other adverse reactions had no statistical significance(P>0.05).The quality of life in the observation group was better than that in the control group,the difference was statistically significant(Z=2.895,P<0.05).The 1-year survival rate,3-year survival rate and survival time of the observation group were better than those of the control group,the differences were statistically significant(P<0.05).Conclusion Adopting rituximab monoclonal antibody and high-dose methotrexate for treating primary central nervous system lymphoma can improve the treatment effective rate,improves the patient′s living quality and survival rate,and is worth promotion within the clinical scope.