She Chunhua, Tan Licai, Li Peng, Ma Li, Li Wenliang
Department of Neuro-oncology and Neurosurgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China.
Zhonghua Xue Ye Xue Za Zhi. 2015 Apr;36(4):282-5. doi: 10.3760/cma.j.issn.0253-2727.2015.04.004.
To explore clinical characteristics， treatment and prognosis of primary central nervous system lymphoma(PCNSL).
Retrospective analysis, Kaplan-Meier analysis and Log-rank test were conducted on 30 PCNSL patients from 2006 to 2014 in our hospital.
The median age of this cohort (14 males and 16 females) was 57.4 years old. 18 cases had single tumor, 12 cases multiple. 17 cases presentd with intracranial hypertension and 13 cases focal neurological deficits. 13 cases (62%) were diffuse large B cell lymphoma. About 60% patients received combination therapy including surgery, radiotherapy or chemotherapy. 63.3% complete remission rate (CR) was achieved for all patients. Kaplan-Meier analysis and Log-rank test showed the median overall survival (OS) was 24 months, the rates of 2-year survival, 5-year survival, 6-month progression-free survival(PFS) and 1-year free-progressed survival (PFS) were as of 46.7%, 13.3%, 60.0% and 43.3% respectively. The median OS of 11 patients received whole brain radiotherapy(WBRT)combined with chemotherapy was 48 months. The median OS of 7 patients treated with stereotactic radiosurgery(SRS) combined with chemotherapy had no significant difference when compared to the former (P=0.233). Survive analysis showed that age was prognostic factor for PCNSL patients(P=0.030).
Diffuse large B cell lymphoma was the main type of PCNSL, single or multiple location, presented with increased intracranial hypertension or focal neurological deficits. Age was the key prognostic factor for patients. Surgery was suitable for patients with supertentorial and superficial tumor or with acute intracranial hypertension syndrome. SRS was a feasible local therapy which alleviated the symptoms and led to less toxicity. PCNSL patients might benefit from multimode therapy.
探讨原发性中枢神经系统淋巴瘤（PCNSL）的临床特征、治疗方法及预后。
对我院2006年至2014年收治的30例PCNSL患者进行回顾性分析、Kaplan-Meier分析及Log-rank检验。
该队列（14例男性，16例女性）的中位年龄为57.4岁。18例为单发病灶，12例为多发病灶。17例表现为颅内高压，13例出现局灶性神经功能缺损。13例（62%）为弥漫性大B细胞淋巴瘤。约60%的患者接受了包括手术、放疗或化疗在内的联合治疗。所有患者的完全缓解率（CR）为63.3%。Kaplan-Meier分析及Log-rank检验显示，中位总生存期（OS）为24个月，2年生存率、5年生存率、6个月无进展生存期（PFS）及1年无进展生存率（PFS）分别为46.7%、13.3%、60.0%及43.3%。11例接受全脑放疗（WBRT）联合化疗患者的中位OS为48个月。7例接受立体定向放射外科治疗（SRS）联合化疗患者的中位OS与前者相比无显著差异（P=0.233）。生存分析显示，年龄是PCNSL患者的预后因素（P=0.030）。
弥漫性大B细胞淋巴瘤是PCNSL的主要类型，可为单发病灶或多发病灶，表现为颅内高压或局灶性神经功能缺损。年龄是患者的关键预后因素。手术适用于幕上及浅表肿瘤或伴有急性颅内高压综合征的患者。SRS是一种可行的局部治疗方法，可缓解症状且毒性较小。PCNSL患者可能从多模式治疗中获益。
