Mou Kun, Gu Wei-Wei, Gu Cui-Hua, Qi Jiu-De
Department of Oncology, People's Hospital of Laiwu, Laiwu 271100, Shandong Province, China.
Department of Oncology, People's Hospital of Laiwu, Laiwu 271100, Shandong Province, China. E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2017 Oct;25(5):1406-1409. doi: 10.7534/j.issn.1009-2137.2017.05.021.
To explore the curative efficacy of methotrexate(MTX) combined with rituxan for treating patients with primary central nervous system(CNS) lymphoma.
One hundred patients with primary CNS lymphoma in our hospital were randomly divided into targeted treatment group(50 cases) and traditional treatment group (50 cases). Targeted treatment group adopted the therapy of high-dose methotrexate combined with rituxan, the traditional treatment group adopted the high-dose methotrexate combined with whole brain radiotherapy. The results of relevant imaging examination, clinical data, imaging, follow-up and the survival time were analysed and compared between these 2 groups.
In the targeted therapy group, there were 33 cases in CR, 9 cases were in stable condition, and 5 cases were in partial response, and 3 cases in the progressive stage. In the group of traditional treatment group, 29 cases reached complete remission, 5 cases were in stable condition, 11 cases were in partial response, and 5 cases were in the progressive stage. In the targeted treatment group and traditional treatment group, the median progression-free survival time was 28 and 11 months, respectively.
The first choice for treatment scheme of PCNSL is high-dose methotrexate chemotherapy combined with whole brain radiotherapy, that showed a certain curative effect, but the adverse reactions are larger, and a big late neuro toxic reaction may occur, while high-dose methotrexate combined PCNSL rituxan treatment shows high curative effect, less adverse reaction and low side effects. This treatment also has a more positive value for the elderly patients with PCNSL.
探讨甲氨蝶呤（MTX）联合利妥昔单抗治疗原发性中枢神经系统（CNS）淋巴瘤患者的疗效。
将我院100例原发性中枢神经系统淋巴瘤患者随机分为靶向治疗组（50例）和传统治疗组（50例）。靶向治疗组采用大剂量甲氨蝶呤联合利妥昔单抗治疗，传统治疗组采用大剂量甲氨蝶呤联合全脑放疗。对两组患者的相关影像学检查结果、临床资料、影像学表现、随访情况及生存时间进行分析比较。
靶向治疗组中，完全缓解（CR）33例，病情稳定9例，部分缓解5例，疾病进展3例。传统治疗组中，29例达到完全缓解，病情稳定5例，部分缓解11例，疾病进展5例。靶向治疗组和传统治疗组的无进展生存期（PFS）中位数分别为28个月和11个月。
原发性中枢神经系统淋巴瘤治疗方案的首选是大剂量甲氨蝶呤化疗联合全脑放疗，该方案显示出一定疗效，但不良反应较大，可能会出现严重的晚期神经毒性反应，而大剂量甲氨蝶呤联合利妥昔单抗治疗原发性中枢神经系统淋巴瘤疗效高、不良反应少、副作用低。该治疗方案对老年原发性中枢神经系统淋巴瘤患者也具有更积极的价值。
