Donahue B R, Sullivan J W, Cooper J S
Division of Radiation Oncology, New York University Medical Center, New York 10016, USA.
Cancer. 1995 Jul 15;76(2):328-32. doi: 10.1002/1097-0142(19950715)76:2<328::aid-cncr2820760225>3.0.co;2-7.
In light of the steadily improving capability to treat opportunistic infections, the authors reviewed their recent experience with short course empiric radiotherapy for the treatment of human immunodeficiency virus (HIV)-associated presumed central nervous system (CNS) lymphoma.
Medical records were reviewed of 32 previously unreported HIV-infected patients who had computed tomography and/or magnetic resonance imaging findings consistent with lymphoma, whose lesions had failed to respond to antitoxoplasmosis therapy and therefore subsequently treated with empiric radiotherapy to the cranium and meninges, nearly always 3000 cGy in 10 fractions.
The majority of patients were in poor general condition (median Karnofsky score = 50) when radiotherapy was initiated. Fifty percent improved during or after radiation. Median survival was 2.1 months.
Despite progress made in the past several years in the treatment of opportunistic infections and brief clinical response to radiotherapy, patients with acquired immunodeficiency syndrome who have a presumed diagnosis of CNS lymphoma continue to have extremely poor survival. Early biopsy in patients with lesions that fail to respond to empiric antitoxoplasmosis treatment or with lesions radiographically most consistent with lymphoma may improve outcome.
鉴于治疗机会性感染的能力不断提高，作者回顾了他们近期采用短程经验性放疗治疗人类免疫缺陷病毒（HIV）相关的疑似中枢神经系统（CNS）淋巴瘤的经验。
回顾了32例既往未报告的HIV感染患者的病历，这些患者的计算机断层扫描和/或磁共振成像结果与淋巴瘤相符，其病变对抗弓形虫病治疗无反应，因此随后对颅骨和脑膜进行经验性放疗，几乎均为10次分割共3000厘戈瑞。
开始放疗时，大多数患者一般状况较差（卡氏评分中位数=50）。50%的患者在放疗期间或放疗后病情有所改善。中位生存期为2.1个月。
尽管过去几年在治疗机会性感染方面取得了进展，且放疗有短暂的临床反应，但疑似诊断为中枢神经系统淋巴瘤的获得性免疫缺陷综合征患者的生存状况仍然极差。对于经验性抗弓形虫病治疗无反应的病变患者或影像学上最符合淋巴瘤的病变患者，早期活检可能改善预后。
