替莫唑胺为主的化疗联合放疗治疗原发中枢神经系统淋巴瘤的临床观察

Clinical Observation of Primary Central Nervous System Lymphoma Patients with Treatment of Temozolomide-based Chemotherapy and Radiation Therapy Treatments

    摘要
  • 摘要:
      目的  评价以替莫唑胺为主的化疗联合放疗治疗原发中枢神经系统淋巴瘤(PCNSL)的疗效及不良反应。
      方法  对2006年6月至2012年3月山东省肿瘤医院收治的24例PCNSL患者采用全脑放疗同步替莫唑胺化疗之后, 给予替莫唑胺+奈达铂+长春新碱化疗方案行6~8个周期的辅助化疗。观察患者肿瘤缓解状态、总生存期及不良反应。
      结果  24例均完成治疗。随访3~63个月, 中位生存时间为25个月, 治疗后CR者41.7%(10/24), PR者29.2%(7/24), SD者12.5%(3/24), PD者16.7%(4/24), 客观肿瘤缓解率(ORR)为70.8%。Kaplan-Meier分析显示该治疗方案优于大剂量甲氨蝶呤(HD-MTX)联合放疗治疗PCNSL的效果, 亦优于单药替莫唑胺治疗PCNSL的效果, 且不良反应小。
      结论   替莫唑胺为主的化疗联合放疗治疗PCNSL较安全、效果好。

     

    Abstract:
      Objective   To evaluate the therapeutic efficacy and toxicity of novel temozolomide-based chemotherapy regimen with radiotherapy for treating primary central nervous system lymphoma (PCNSL).
      Methods   Twenty-four patients were treated by concurrent chemoradiation with temozolomide, after which adjuvant chemotherapy (temozolomide, nedaplatin, and vincristine) was given for 6-8 cycles. Some states were observed, including remission rate, overall survival (OS), and toxicity.
      Results   The 24 patients were followed up for 3 months to 63 months. The median overall survival was 25 months. Ten patients (41.7%) achieved complete response (CR), whereas seven patients (29.2%) achieved partial response (PR). Stable disease was documented in three patients (12.5%), whereas progressive disease occurred in four patients (16.7%). The objective response rate (ORR) was 70.8%. Kaplan-Meier analysis shows that the new treatment is better and results in less adverse reactions than does the combination of high-dose methotrexae (HD-MTX) and radiotherapy, and superior to the single-agent temozolomide treatment of PCNSL.
      Conclusion   The temozolomide-based chemo- therapy regimen with radiotherapy for PCNSL treatment is safe and effective.

     

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