Mohile Nimish A, Abrey Lauren E
Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Semin Radiat Oncol. 2007 Jul;17(3):223-9. doi: 10.1016/j.semradonc.2007.02.008.
Primary central nervous system lymphoma (PCNSL) is a rare form of non-Hodgkin lymphoma (NHL) that is restricted entirely to the brain, leptomeninges, eyes, and rarely the spinal cord. It typically presents with focal neurologic symptoms and is characterized by diffuse infiltration of the brain. Corticosteroids are useful for symptomatic treatment but can interfere with definitive pathological diagnosis. PCNSL is radiosensitive and responds to whole-brain radiotherapy. The use of preirradiation high-dose methotrexate-based regimens has significantly improved response rates and patient survival. Longer survival, however, is often marred by devastating neurotoxicity to which the elderly are particularly susceptible. Newer regimens aim to minimize such toxicity while maintaining the survival benefit of combined modality treatment.
原发性中枢神经系统淋巴瘤（PCNSL）是一种罕见的非霍奇金淋巴瘤（NHL），完全局限于脑、软脑膜、眼，很少累及脊髓。它通常表现为局灶性神经症状，其特征是脑的弥漫性浸润。皮质类固醇对症状性治疗有用，但会干扰明确的病理诊断。PCNSL对放疗敏感，对全脑放疗有反应。放疗前使用基于大剂量甲氨蝶呤的方案显著提高了缓解率和患者生存率。然而，较长的生存期常常因严重的神经毒性而受到影响，老年人对此尤其易感。新的方案旨在将这种毒性降至最低，同时维持综合治疗方式的生存获益。
