Clinical Observation of Primary Central Nervous System Lymphoma Patients with Treatment of Temozolomide-based Chemotherapy and Radiation Therapy Treatments
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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。 -
关键词:
- 原发性中枢神经系统淋巴瘤 /
- 替莫唑胺 /
- 放射疗法 /
- 药物疗法
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. -
Key words:
- Primary central nervous system lymphoma /
- Temozolomide /
- Radiotherapy /
- Chemotherapy
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表 1 24例PCNSL患者的临床特征
Table 1. The clinical features of 24 patients with PCNSL
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