Gao Jing, Lv Li-Wei, Yang Jing, Wang He-Nan, Wang Liang
Department of Hematology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Cancer Med. 2025 Aug;14(15):e71092. doi: 10.1002/cam4.71092.
Vitreoretinal lymphoma (VRL) is regarded as a subtype of primary central nervous system lymphoma (PCNSL). Hence, extending progression-free survival (PFS) is crucial for enhancing the prognosis of VRL patients. Nevertheless, a lack of standard treatment options currently exists for VRL. This systematic review aims to explore the most optimal treatment strategy.
The methods for this systematic review and meta-analysis adhered to PRISMA guidelines and followed a protocol registered on the PROSPERO registry. A search was conducted on PubMed, Embase, and Scopus up to October 14, 2023, using predefined search terms. Primary endpoints included overall response rate (ORR) and complete response rate (CRR), while secondary endpoints comprised overall survival (OS) and progression-free survival (PFS).
Thirty-seven studies comprising 801 patients were included in the meta-analysis. The pooled CRR was 85%, and the ORR was 93%. The pooled 1-year PFS was 83%, and the 2-year PFS was 58%. The 1-year OS was 92%, and the 2-year OS was 80%. The combined median PFS was 22.87 months, and the median OS was 51.19 months. Survival analysis of the extracted data showed significant associations between PFS and OS with systemic therapy (p = 0.00098 and p = 0.0091) and multi-strategy combination therapy (p = 0.0081 and p = 0.007); however, age, gender, and bilateral involvement exhibited no significant relationship (p > 0.05).
In conclusion, while existing treatment strategies have led to higher remission rates and longer OS for VRL patients, PFS remains suboptimal. The primary focus of future clinical and basic research will be to explore effective treatment strategies for controlling disease recurrence or progression.
This meta-analysis was registered in the international prospective register of systematic reviews (PROSPERO) (CRD42023400305).
玻璃体视网膜淋巴瘤（VRL）被视为原发性中枢神经系统淋巴瘤（PCNSL）的一种亚型。因此，延长无进展生存期（PFS）对于改善VRL患者的预后至关重要。然而，目前VRL缺乏标准的治疗方案。本系统评价旨在探索最优化的治疗策略。
本系统评价和荟萃分析的方法遵循PRISMA指南，并遵循在PROSPERO注册中心注册的方案。截至2023年10月14日，使用预定义的检索词在PubMed、Embase和Scopus上进行了检索。主要终点包括总缓解率（ORR）和完全缓解率（CRR），次要终点包括总生存期（OS）和无进展生存期（PFS）。
荟萃分析纳入了37项研究，共801例患者。汇总的CRR为85%，ORR为93%。汇总的1年PFS为83%，2年PFS为58%。1年OS为92%，2年OS为80%。合并的中位PFS为22.87个月，中位OS为51.19个月。对提取数据的生存分析显示，PFS和OS与全身治疗（p = 0.00098和p = 0.0091）以及多策略联合治疗（p = 0.0081和p = 0.007）之间存在显著关联；然而，年龄、性别和双侧受累未显示出显著关系（p > 0.05）。
总之，虽然现有治疗策略已使VRL患者的缓解率更高且OS更长，但PFS仍不尽人意。未来临床和基础研究的主要重点将是探索控制疾病复发或进展的有效治疗策略。
本荟萃分析已在国际前瞻性系统评价注册库（PROSPERO）（CRD42023400305）中注册。
