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124 例原发性中枢神经系统淋巴瘤患者的生存结局和治疗经验。

Survival outcomes and treatment experience of 124 patients with primary central nervous system lymphoma.

机构信息

Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, China.

National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.

出版信息

Strahlenther Onkol. 2024 Sep;200(9):760-773. doi: 10.1007/s00066-024-02219-5. Epub 2024 Mar 11.

Abstract

PURPOSE

Primary central nervous system lymphoma (PCNSL) is a rare malignancy of the central nervous system with high invasiveness. There is little consensus on the treatment of PCNSL. This study retrospectively studied data from PCNSL patients in a single center to summarize treatment experience and explore prognostic factors.

METHODS

Survival curves were drawn using the Kaplan-Meier method and prognostic factors were analyzed using Cox's hazards model.

RESULTS

In multivariate analysis, cerebrospinal fluid lactic acid dehydrogenase (CSF LDH; p = 0.005 and p = 0.002), neutrophil to lymphocyte ratio (NLR; p = 0.014 and p = 0.038), and completion of four cycles of induction therapy (p < 0.001and p < 0.001) were significant and independent predictors of overall survival (OS) and progression-free survival (PFS), respectively.

CONCLUSION

On the basis of this study, we propose that PCNSL patients should receive early induction therapy with sufficient cycles. Subsequent consolidation therapy can prevent relapses and improve survival. In patients with PCNSL, the independent prognostic factors for OS and PFS were CSF LDH level, NLR, and full cycles of induction therapy.

摘要

目的

原发性中枢神经系统淋巴瘤(PCNSL)是一种中枢神经系统侵袭性很强的罕见恶性肿瘤。PCNSL 的治疗方法尚未达成共识。本研究回顾性分析了单中心 PCNSL 患者的数据,以总结治疗经验并探讨预后因素。

方法

采用 Kaplan-Meier 法绘制生存曲线,采用 Cox 风险模型分析预后因素。

结果

多因素分析显示,脑脊液乳酸脱氢酶(CSF LDH;p=0.005 和 p=0.002)、中性粒细胞与淋巴细胞比值(NLR;p=0.014 和 p=0.038)以及完成 4 个周期诱导治疗(p<0.001 和 p<0.001)是总生存(OS)和无进展生存(PFS)的显著且独立的预后因素。

结论

基于本研究,我们建议 PCNSL 患者应接受足够周期的早期诱导治疗。随后的巩固治疗可以预防复发并提高生存率。在 PCNSL 患者中,OS 和 PFS 的独立预后因素是 CSF LDH 水平、NLR 和完整的诱导治疗周期。

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