中枢神经系统的淋巴瘤
Kiyotaka Yokogami1, Minako Azuma2, Hideo Takeshima3
1Departments of Neurosurgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan. akatoyik@med.miyazaki-u.ac.jp.
Advances in experimental medicine and biology
|July 15, 2023
概括
主要中枢神经系统淋巴瘤 (PCNSL) 是一种罕见的非霍奇金淋巴瘤. 治疗包括化疗和辐射,对于耐火病例的新选择可以改善预后.
科学领域:
- 在瘤学瘤学.
- 神经学 神经学
- 血液学 血液学 血液学
背景情况:
- 主要中枢神经系统淋巴瘤 (PCNSL) 是一种罕见的局外非霍奇金淋巴瘤 (NHL),局限于中枢神经系统.
- 它约占中枢神经系统原发性瘤的2.4-4.9%,最近在老年患者中增加.
- 在组织学上,PCNSL涉及B细胞爆发,对PAX5,CD19和CD20等特定标记物呈阳性.
研究的目的:
- 为提供初级中枢神经系统淋巴瘤 (PCNSL) 的概述.
- 讨论PCNSL的诊断特征,治疗策略和预后因素.
- 突出PCNSL管理的最新进展和挑战.
主要方法:
- 关于PCNSL诊断和治疗的当前文献的综述.
- 对CT,MR成像和PET扫描的特征性成像发现的分析.
- 标准和新兴治疗方法的摘要,包括化疗和向治疗.
主要成果:
- PCNSL表现出特有的成像外观.
- 以HD-MTX为基础的化疗,包括或不包括rituximab和辐射,是第一线治疗.
- 由于神经毒性风险,建议对老年患者进行联合化疗或减少剂量的辐射.
结论:
- 对于PCNSL的预后有所改善,平均整体存活期为26个月,5年存活率为31%.
- 年龄较小 (<60岁) 和良好的世卫组织绩效状况 (<或=1) 与更好的生存率有关.
- 对于复发性PCNSL的既定标准护理,需要进一步的研究,像ibrutinib这样的药物显示出有前途.
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