Ferreri A J, Dell Oro S, Reni M
Department of Radiochemotherapy, San Raffaele H Scientific Institute, Milan, Italy.
Forum (Genova). 2003;13(1):33-45.
The best therapeutic management in primary central nervous system lymphomas remains to be defined because of current knowledge on these malignancies results from small retrospective series with a short follow-up, a limited number of prospective studies with some methodological pitfalls and a single published randomised trial. This review focuses on the current therapeutic approaches, most commonly used drugs, role of intrathecal chemotherapy, and indications for consolidation radiotherapy, providing recommendations for ordinary clinical practice. Some important therapeutic issues, such as the management of meningeal and intraocular lymphomas, as well as the relevance of salvage therapy as a playground for evaluation of new drugs are also analysed. Finally, the main open questions, as well as current and expected investigation trends are discussed.
由于目前关于原发性中枢神经系统淋巴瘤的知识来自小型回顾性系列研究,随访时间短,前瞻性研究数量有限且存在一些方法学缺陷,以及仅有一项已发表的随机试验,因此原发性中枢神经系统淋巴瘤的最佳治疗管理仍有待确定。本综述重点关注当前的治疗方法、最常用的药物、鞘内化疗的作用以及巩固放疗的适应症,为普通临床实践提供建议。还分析了一些重要的治疗问题,如脑膜和眼内淋巴瘤的管理,以及挽救治疗作为评估新药的试验场的相关性。最后,讨论了主要的未解决问题以及当前和预期的研究趋势。