Bellefqih S, Mezouri I, Khalil J, Bazine A, Diakité A, El Kacimi H, Kebdani T, Benjaafar N
Service de radiothérapie, Institut national d'oncologie, avenue Allal El-Fassi, 10100 Rabat, Maroc; Université Mohammed-V Souissi, 10100 Rabat, Maroc.
Service de radiothérapie, Institut national d'oncologie, avenue Allal El-Fassi, 10100 Rabat, Maroc; Université Mohammed-V Souissi, 10100 Rabat, Maroc.
Cancer Radiother. 2014 Nov;18(7):685-92. doi: 10.1016/j.canrad.2014.06.025. Epub 2014 Oct 18.
Primary central nervous system lymphoma is a rare extranodal form of non-Hodgkin lymphoma with an aggressive course and unsatisfactory outcome. Historically, whole-brain radiotherapy was the sole treatment for patients with primary central nervous system lymphoma, with high response rates but typically, this did not result in long-lasting remissions. The addition of high-dose methotrexate-based chemotherapy regimens to whole-brain radiotherapy has significantly improved patients' outcome, but has resulted in a higher incidence of late neurotoxicity, particularly in elderly patients. To date, the role of consolidation radiotherapy is controversial, and some investigators have developed alternative strategies aiming at avoiding immediate irradiation or using a reduced radiotherapy dose to the whole-brain with promising results.
原发性中枢神经系统淋巴瘤是一种罕见的结外非霍奇金淋巴瘤,病程侵袭性强,预后不理想。从历史上看,全脑放疗是原发性中枢神经系统淋巴瘤患者的唯一治疗方法,缓解率高,但通常不会带来持久缓解。在全脑放疗基础上加用基于大剂量甲氨蝶呤的化疗方案显著改善了患者的预后,但导致迟发性神经毒性的发生率更高,尤其是在老年患者中。迄今为止,巩固放疗的作用存在争议,一些研究人员已经制定了替代策略,旨在避免立即进行放疗或对全脑使用降低的放疗剂量,取得了有希望的结果。