Dong Yafei, Pan Li, Wang Binjiang, Wang Enmin, Zhang Nan, Cai Peiwu, Dai Jiazhong
Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200233, China.
Chin Med J (Engl). 2003 Aug;116(8):1166-70.
To explore the therapeutic alternatives and evaluate the related clinical results of patients with primary central nervous system lymphoma (PCNSL) treated with gamma knife radiosurgery (GKS).
From January 1995 to December 2001, 44 patients suffering from PCNSL, who had undergone stereotactic biopsy or craniotomy, and who had received a confirmed diagnosis through pathological examination, were treated with GKS. All cases were followed up for 1 - 46 months with an average postoperative period of 27 months. The clinical materials, image features, treatment methods and results of follow-up, were retrospectively reviewed.
The symptoms and signs of the patients were markedly improved within 1 - 3 weeks after GKS. The Kanofsky performance status was also improved from a preoperative average of 40% to a postoperative one of 90%. Thirty-eight patients (86.36%) were in complete remission (CR), the other six (13.63%) were in partial remission (PR). The local control rate reached 100%, and the median survival time was 26.5 months. The main side effect was brain edema, which can be treated with dexamethasone and mannitol.
GKS is a safe and effective method in multimodality treatment of PCNSL. A stereotactic biopsy coupled with GKS is the first choice for diagnosis and treatment. Adjuvant chemotherapy or radiotherapy should then be given according to the patient's condition.
探讨原发性中枢神经系统淋巴瘤（PCNSL）患者接受伽玛刀放射外科治疗（GKS）的治疗选择并评估相关临床结果。
1995年1月至2001年12月，44例经立体定向活检或开颅手术且病理检查确诊为PCNSL的患者接受了GKS治疗。所有病例均随访1至46个月，术后平均随访期为27个月。对临床资料、影像特征、治疗方法及随访结果进行回顾性分析。
患者症状和体征在GKS治疗后1至3周内明显改善。卡诺夫斯基功能状态评分也从术前平均40%提高到术后90%。38例（86.36%）患者完全缓解（CR），另外6例（13.63%）部分缓解（PR）。局部控制率达100%，中位生存时间为26.5个月。主要副作用为脑水肿，可通过地塞米松和甘露醇治疗。
GKS是PCNSL多模式治疗中的一种安全有效的方法。立体定向活检联合GKS是诊断和治疗的首选。然后应根据患者情况给予辅助化疗或放疗。
