年轻患者中初级中枢神经系统淋巴瘤的第一线治疗方法
Laurence Schenone1,2, Marion Alcantara3,4, Caroline Houillier5
1Department of Hematology, CHRU de Nancy, Hôpitaux de Brabois.
Current opinion in oncology
|July 27, 2023
概括
高剂量甲状腺酸盐 (HD-MTX) 化疗是初级中枢神经系统淋巴瘤的主要治疗方法. 通过自身干细胞移植 (ASCT) 进行密集整合,可改善符合条件的患者到70岁的生存率.
科学领域:
- 神经瘤学神经瘤学
- 血液学 血液学 血液学
- 临床试验 临床试验
背景情况:
- 主要中枢神经系统淋巴瘤 (PCNSL) 治疗已经显著发展.
- 目前的治疗策略旨在最大限度地提高疗效,同时最大限度地降低长期毒性.
研究的目的:
- 审查PCNSL免疫能力较强的患者目前的第一线治疗方法.
- 讨论正在进行的研究和新兴的治疗方法.
主要方法:
- 对PCNSL治疗的当前文献和临床试验数据的审查.
- 导入,整合和维护策略的分析.
- 对放射治疗和化疗方案的评估.
主要成果:
- 基于高剂量甲基酸盐 (HD-MTX) 的多化学疗法是诱导治疗的基石,尽管正在研究最佳方案.
- 与自身干细胞移植 (ASCT) 进行的强化化疗法 (IC) 改善了患者至70岁的生存率.
- 减少全脑放射治疗 (WBRT) 是年轻患者的选择,但老年人的安全性需要进一步研究.
结论:
- 基于HD-MTX的诱导仍然是标准的,目前正在进行治疗方案优化的试验.
- IC + ASCT对70岁以下的符合条件的患者有益.
- 需要进一步的研究来确定最佳的巩固,维护和放射治疗策略,特别是对于老年患者.
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