Blay J Y
Unité cytokine et cancer, Centre Léon-Bérard, Lyon, France.
Bull Cancer. 1997 Oct;84(10):976-80.
Cerebral non Hodgkin's lymphomas (NHL) of immunocompetent patients are rare disease (1% of all NHL), but their incidence has been steadily increasing in the last 20 years. Most cerebral NHL are diffuse large cell NHL with a B phenotype. These tumors are most often localized in the central nervous system, the eye or meninges; other systemic tumor sites are rare, either at initial diagnosis and relapse. The overall survival of primary cerebral lymphoma (PCL) is poor in the published retrospective series with a median survival in the range of 12 to 16 months and a 5 year survival between 5 et 20%. PCL are however curable brain tumors, and the outcome of these patients has probably improved in the past 10 years, using a multidisciplinary therapeutic approach. Complete resection of the tumor dose not improve the outcome of these patients. The treatment of PCL relies on combinations of chemotherapy and radiotherapy, but the type of regimen and the dose to the brain are still a matter of debate, in particular because of late neurological sequelae. Multicentric prospective clinical trials in France and Europe will provide answers to these questions in the next years.
免疫功能正常患者的脑非霍奇金淋巴瘤(NHL)是一种罕见疾病(占所有NHL的1%),但其发病率在过去20年中一直在稳步上升。大多数脑NHL是具有B表型的弥漫性大细胞NHL。这些肿瘤最常定位于中枢神经系统、眼睛或脑膜;其他全身肿瘤部位在初诊和复发时都很少见。在已发表的回顾性系列研究中,原发性脑淋巴瘤(PCL)的总体生存率较差,中位生存期在12至16个月之间,5年生存率在5%至20%之间。然而,PCL是可治愈的脑肿瘤,在过去10年中,采用多学科治疗方法,这些患者的预后可能有所改善。肿瘤的完全切除并不能改善这些患者的预后。PCL的治疗依赖于化疗和放疗的联合,但治疗方案的类型和脑部的剂量仍存在争议,特别是因为存在晚期神经后遗症。法国和欧洲的多中心前瞻性临床试验将在未来几年为这些问题提供答案。