Makino Keishi, Nakamura Hideo, Kudo Mareina, Takeshima Hideo, Kuratsu Jun-Ichi
Department of Neurosurgery, Kumamoto University Graduate School, Japan.
Neurol Med Chir (Tokyo). 2007 May;47(5):229-32. doi: 10.2176/nmc.47.229.
An 80-year-old woman presented with primary central nervous system (CNS) lymphoma manifesting as progressive disorientation and loss of activity. She received three cycles of high-dose methotrexate. The tumor shrank after two cycles and her mental status improved, but she suffered tumor recurrence. The second-line treatment consisted of four cycles of rituximab but the tumor enlarged. She was then treated with three cycles of temozolomide. Magnetic resonance imaging revealed no evidence of disease. Her mental status and performance status improved, and she suffered no toxicity. She is able to pursue her daily life without recurrence after 16 cycles of temozolomide. Temozolomide may be effective against relapsed primary CNS lymphoma without causing neurotoxicity in the elderly.
一名80岁女性因原发性中枢神经系统（CNS）淋巴瘤就诊，表现为进行性定向障碍和活动能力丧失。她接受了三个周期的大剂量甲氨蝶呤治疗。两个周期后肿瘤缩小，她的精神状态有所改善，但肿瘤复发。二线治疗包括四个周期的利妥昔单抗，但肿瘤增大。然后她接受了三个周期的替莫唑胺治疗。磁共振成像显示无疾病证据。她的精神状态和功能状态有所改善，且未出现毒性反应。在接受16个周期的替莫唑胺治疗后，她能够正常生活且未复发。替莫唑胺可能对复发性原发性中枢神经系统淋巴瘤有效，且不会对老年人造成神经毒性。
