University of Nebraska Medical Center, Division of Hematology and Oncology, Omaha, NE, USA 68198-7680.
Clin Med Insights Oncol. 2012;6:219-31. doi: 10.4137/CMO.S7752. Epub 2012 May 21.
Primary central nervous system lymphoma (PCNSL) constitutes a rare group of extranodal non-Hodgkin's lymphoma (NHL) primarily of B cell origin. It occurs in both immuno-competent and immune-compromised patients. High dose m ethotrexate (HD-MTX) based chemotherapy is the standard therapy. Chemotherapy with whole brain radiation therapy (WBRT) improves response rates and survival compared with WBRT alone. However, due to the increased risk for neurotoxicity with WBRT, recent studies have focused on using chemotherapy alone. Methotrexate based multi-agent chemotherapy without WBRT is associated with similar t reatment rates and survival compared with regimens that include WBRT although controlled trials have not been performed. Because of the low incidence of this disease, it is difficult to conduct randomized controlled trials. In this article we have discussed about the past, present and emerging treatment options in patients with PCNSL.
原发性中枢神经系统淋巴瘤（PCNSL）构成了一组罕见的结外非霍奇金淋巴瘤（NHL），主要来源于 B 细胞。它发生在免疫功能正常和免疫功能低下的患者中。大剂量甲氨蝶呤（HD-MTX）为基础的化疗是标准治疗。与单独 WBRT 相比，化疗联合全脑放疗（WBRT）可提高反应率和生存率。然而，由于 WBRT 引起神经毒性的风险增加，最近的研究集中在单独使用化疗。不联合 WBRT 的基于甲氨蝶呤的多药化疗与包括 WBRT 的方案相比，具有相似的治疗率和生存率，尽管尚未进行对照试验。由于这种疾病的发病率低，很难进行随机对照试验。在本文中，我们讨论了 PCNSL 患者过去、现在和新兴的治疗选择。
