Sopittapan Thanya, Tunthanathip Thara, Kaewborisutsakul Anukoon
Neurological Surgery Unit, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat-Yai, Songkhla, Thailand.
Asian J Neurosurg. 2020 Aug 28;15(3):560-565. doi: 10.4103/ajns.AJNS_208_20. eCollection 2020 Jul-Sep.
Primary central nervous system lymphoma (PCNSL) is an uncommon type of brain tumor that has an aggressive disease course. Its outcomes, including factor-related outcomes, are therefore not well established in our country.
This study aims to investigate the outcome and prognostic factors in PCNSL patients at our institute.
Retrospective study in a single university hospital.
We reviewed consecutive cases of newly diagnosed PCNSL at Prince of Songkla University from 2005 to 2018. The data were collected to evaluate the treatment outcomes and prognostic factors.
The Kaplan-Meier method for survival analysis, and Cox regression for variable analysis.
Eighty-seven patients met the inclusion criteria. Patients were predominantly male, and their mean age was 58.8 ± 11.2 years. Only four patients were infected with HIV. Motor weakness was the most common presentation, and neuroimaging revealed multiple lesions in 56.3% of patients. The patients were divided into four groups according to treatment modality: palliative treatment, whole-brain radiotherapy (WBRT) alone, chemotherapy (CMT) alone, and combined WBRT and CMT groups. The median overall survival was 7 months. The 1-, 2-, and 5-year survival rates were 29%, 21.5%, and 4.6%, respectively. The age of >60 years was a significant poor prognostic factor. In addition, patients who received combined treatment exhibited the highest survival rate.
PCNSL has a low survival rate, even in the present era. Older age is the most substantial factor associated with unfavorable outcomes. The most effective treatment is combined with WBRT and CMT.
原发性中枢神经系统淋巴瘤（PCNSL）是一种罕见的脑肿瘤，病程进展迅速。因此，其预后，包括与因素相关的预后，在我国尚未完全明确。
本研究旨在调查我院PCNSL患者的预后及预后因素。
在一家大学医院进行的回顾性研究。
我们回顾了2005年至2018年宋卡王子大学新诊断的PCNSL连续病例。收集数据以评估治疗结果和预后因素。
采用Kaplan-Meier法进行生存分析，Cox回归进行变量分析。
87例患者符合纳入标准。患者以男性为主，平均年龄为58.8±11.2岁。仅4例患者感染HIV。运动无力是最常见的表现，神经影像学显示56.3%的患者有多处病变。根据治疗方式将患者分为四组：姑息治疗组、单纯全脑放疗（WBRT）组、单纯化疗（CMT）组以及WBRT与CMT联合组。中位总生存期为7个月。1年、2年和5年生存率分别为29%、21.5%和4.6%。年龄>60岁是一个显著的不良预后因素。此外，接受联合治疗的患者生存率最高。
即使在当今时代，PCNSL的生存率仍较低。年龄较大是与不良预后相关的最主要因素。最有效的治疗方法是WBRT与CMT联合。
