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新诊断的中枢神经系统原发性淋巴瘤的放射治疗:作用和前景

Alice Thomas^1,2, Caroline Houillier³, Delphine Antoni¹

¹Department of Radiation Oncology, Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France.

Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology

|July 17, 2023

概括

全脑放射治疗 (WBRT) 是主要治疗中枢神经系统淋巴瘤 (PCNSL) 的关键治疗方法,但会引起神经毒性. 现代策略忽略或挑战WBRT,特别是在老年患者中,以改善结果.

科学领域:

神经瘤学神经瘤学
辐射瘤学辐射瘤学
血液学瘤学癌症学

背景情况:

全脑放射疗法 (WBRT) 是治疗初级中枢神经系统淋巴瘤 (PCNSL) 的基石.
从20世纪90年代开始,高剂量甲基基化疗 (基于HD MTX的CT) 的整合显著改善了患者的治疗结果.
结合WBRT和基于高频MTX的CT可以导致显著的延迟神经毒性,特别是在老年患者中.

研究的目的:

审查WBRT在新诊断的PCNSL中不断变化的作用.
讨论目前的治疗策略和PCNSL管理的未来前景.
为临床医生提供关于WBRT在PCNSL治疗中的地位的最新概述.

主要方法:

对PCNSL治疗研究的文献综述,重点关注WBRT和化疗.
对治疗结果的分析,包括疗效和神经毒性.
检查替代和不断发展的治疗方法.

主要成果:

在老年PCNSL患者中,WBRT越来越多地被遗漏或推迟.
自主干细胞移植 (HCT-ASCT) 的高剂量化疗正在成为对年轻患者的WBRT具有挑战性的巩固治疗.
治疗疗效与神经毒性之间的平衡仍然是一个关键的考虑因素.

结论:

在PCNSL治疗中WBRT的作用正在转变,使用减少或推迟的趋势.
正在探索像HCT-ASCT这样的替代策略,以减轻神经毒性,同时保持有效性.
需要进一步的研究来优化PCNSL的治疗模式,平衡生存效益与长期生活质量.

关键词:

中枢神经系统中枢神经系统化学疗法化疗化疗淋巴瘤淋巴瘤是什么神经毒性的作用.辐射疗法辐射疗法

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