【摘要】：目的:探討大劑量甲氨喋呤聯(lián)合利妥昔單克隆抗體治療原發(fā)性中樞神經(jīng)系統(tǒng)淋巴瘤(PCNSL)的療效。方法:選取我科收治的100例原發(fā)性中樞神經(jīng)系統(tǒng)淋巴瘤患者并將他們分為靶向治療組和傳統(tǒng)治療組,各組50例。靶向治療組所采用的治療方法為大劑量甲氨喋呤聯(lián)合利妥昔單克隆抗體治療,傳統(tǒng)治療組所采用的治療方法為傳統(tǒng)的大劑量甲氨喋呤與全腦放療相結(jié)合治療,進(jìn)行相關(guān)的影像學(xué)檢查,統(tǒng)計(jì)兩組的一般臨床資料、影像學(xué)資料、隨訪結(jié)果以及生存時(shí)間并進(jìn)行比較與分析。結(jié)果:在靶向治療組中,完全緩解的病例有33例,病情穩(wěn)定的病例有9例,部分緩解的有5例,病情有進(jìn)展的有3例;而在傳統(tǒng)治療組中,完全緩解的病例有29例,病情穩(wěn)定的病例有5例,部分緩解的有11例,病情進(jìn)展的有5例。靶向治療組與傳統(tǒng)治療組的中位無進(jìn)展生存時(shí)間分別為28個(gè)月和11個(gè)月。結(jié)論:臨床上首選治療PCNSL的方案為大劑量甲氨喋呤化療,與全腦放療相結(jié)合進(jìn)行治療,具有一定的療效,但不良反應(yīng)較大,有很大可能會出現(xiàn)晚期神經(jīng)毒性反應(yīng)。大劑量甲氨喋呤聯(lián)合利妥昔單克隆抗體治療PCNSL,療效較高,不良反應(yīng)較少,副作用較小,在治療老年P(guān)CNSL患者方面也具有更積極的價(jià)值。
[Abstract]:Objective: to evaluate the efficacy of high dose methotrexate combined with rituximab monoclonal antibody in the treatment of primary central nervous system lymphoma (PCNSL). Methods: 100 patients with primary central nervous system lymphoma were selected and divided into two groups: target therapy group and traditional treatment group. The target treatment group was treated with high dose methotrexate combined with rituximab monoclonal antibody, while the traditional treatment group was treated with high dose methotrexate combined with whole brain radiotherapy. The clinical data, imaging data, follow-up results and survival time of the two groups were compared and analyzed. Results: in the targeted treatment group, there were 33 cases of complete remission, 9 cases of stable condition, 5 cases of partial remission, 3 cases of progress, and 29 cases of complete remission in the traditional treatment group. There were 5 cases of stable condition, 11 cases of partial remission and 5 cases of progression. The median progression-free survival time was 28 months and 11 months in the target treatment group and the traditional treatment group, respectively. Conclusion: high dose methotrexate chemotherapy combined with whole brain radiotherapy is the first choice in clinical treatment of PCNSL. High dose methotrexate combined with rituximab monoclonal antibody in the treatment of PCNSLs has higher efficacy, less adverse reactions and less side effects. It also has more positive value in the treatment of elderly patients with PCNSL.
【作者單位】： 萊蕪市人民醫(yī)院腫瘤科;
【分類號】：R739.4
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本文編號：2178381