中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2015年
10期
849-852
,共4页
朱铁楠%王书杰%张薇%李剑%韩冰%段明辉%庄俊玲%蔡华聪%曹欣欣%周道斌
硃鐵楠%王書傑%張薇%李劍%韓冰%段明輝%莊俊玲%蔡華聰%曹訢訢%週道斌
주철남%왕서걸%장미%리검%한빙%단명휘%장준령%채화총%조흔흔%주도빈
淋巴瘤,中枢神经系统肿瘤,原发性%预后
淋巴瘤,中樞神經繫統腫瘤,原髮性%預後
림파류,중추신경계통종류,원발성%예후
Lymphoma,central nervous system primitive%Prognosis
目的：探讨原发中枢神经系统淋巴瘤（PCNSL）的临床特征、治疗方案以及预后相关因素。方法回顾性总结北京协和医院自1999年6月至2012年6月收治的37例PCNSL患者临床资料，对患者临床特征、治疗以及预后相关因素进行分析。结果全部37例PCNSL患者中位发病年龄57（17~78）岁，男女比为2.7∶1。以颅内高压和智能障碍为最常见临床表现，起病至诊断中位时间1.5（1~24）个月。肿瘤累及部位以大脑半球为主，且多灶病变更为常见。36例经治患者无进展生存（PFS）时间为18.0（95%CI 9.1~26.9）个月，总生存（OS）时间为36.0（95%CI 21.7~50.3）个月，3年累计OS率为46.9%。放化疗联合治疗与单纯化疗组PFS时间[16.0（95%CI 8.9~23.1）个月对26.0（95%CI 2.9~49.1）个月]及OS时间[36.0（95%CI 2.3~69.7）个月对29.0（95%CI 23.4~34.6）个月]比较，差异均无统计学意义（P=0.401、0.866）。结论 PCNSL预后不佳，化放疗联合并不能显著改善患者生存，其最佳治疗方案应需进一步探索。
目的：探討原髮中樞神經繫統淋巴瘤（PCNSL）的臨床特徵、治療方案以及預後相關因素。方法迴顧性總結北京協和醫院自1999年6月至2012年6月收治的37例PCNSL患者臨床資料，對患者臨床特徵、治療以及預後相關因素進行分析。結果全部37例PCNSL患者中位髮病年齡57（17~78）歲，男女比為2.7∶1。以顱內高壓和智能障礙為最常見臨床錶現，起病至診斷中位時間1.5（1~24）箇月。腫瘤纍及部位以大腦半毬為主，且多竈病變更為常見。36例經治患者無進展生存（PFS）時間為18.0（95%CI 9.1~26.9）箇月，總生存（OS）時間為36.0（95%CI 21.7~50.3）箇月，3年纍計OS率為46.9%。放化療聯閤治療與單純化療組PFS時間[16.0（95%CI 8.9~23.1）箇月對26.0（95%CI 2.9~49.1）箇月]及OS時間[36.0（95%CI 2.3~69.7）箇月對29.0（95%CI 23.4~34.6）箇月]比較，差異均無統計學意義（P=0.401、0.866）。結論 PCNSL預後不佳，化放療聯閤併不能顯著改善患者生存，其最佳治療方案應需進一步探索。
목적：탐토원발중추신경계통림파류（PCNSL）적림상특정、치료방안이급예후상관인소。방법회고성총결북경협화의원자1999년6월지2012년6월수치적37례PCNSL환자림상자료，대환자림상특정、치료이급예후상관인소진행분석。결과전부37례PCNSL환자중위발병년령57（17~78）세，남녀비위2.7∶1。이로내고압화지능장애위최상견림상표현，기병지진단중위시간1.5（1~24）개월。종류루급부위이대뇌반구위주，차다조병변경위상견。36례경치환자무진전생존（PFS）시간위18.0（95%CI 9.1~26.9）개월，총생존（OS）시간위36.0（95%CI 21.7~50.3）개월，3년루계OS솔위46.9%。방화료연합치료여단순화료조PFS시간[16.0（95%CI 8.9~23.1）개월대26.0（95%CI 2.9~49.1）개월]급OS시간[36.0（95%CI 2.3~69.7）개월대29.0（95%CI 23.4~34.6）개월]비교，차이균무통계학의의（P=0.401、0.866）。결론 PCNSL예후불가，화방료연합병불능현저개선환자생존，기최가치료방안응수진일보탐색。
Objective To investigate the characteristics, treatment and outcome of patients with primary central nervous system lymphoma (PCNSL). Methods A total of 37 patients with PCNSL treated in Peking Union Medical College Hospital from June 1999 to June 2012 were enrolled into this retrospective study. The clinical characteristics, results of treatment and prognostic factors were analyzed. Results The median age of 37 patients with PCNSL at diagnosis was 57 years(range 17 to 78 years) with a male to female ratio of 2.7∶1. The symptoms or signs of elevated intracranial pressure and cognitive dysfunction were the most common initial manifestations. The median time period between onset of symptoms and diagnosis was 1.5 months. The majority of lesions were located in the cerebral hemisphere. At a median follow-up of 50 months, the median overall survival for all treated patients was 36.0 months (95%CI 21.7-50.3 months), with a progression-free survival of 18.0 months(95%CI 9.1-26.9 months). The 3-year cumulative survival rate was 46.9%. Compared to chemotherapy alone, combined-modality regimens which did not improve outcome were associated with a greater risk of neurotoxicity. Conclusion The prognosis of PCNSL was still poor, and the optimal treatment strategy for these patients should be explored in the future clinical trials.
