初级中枢神经系统淋巴瘤治疗失败的模式
James R Janopaul-Naylor1,2, Jimmy S Patel1, Manali Rupji3
1Departments of Radiation Oncology.
American journal of clinical oncology
|May 22, 2024
概括
主要中枢神经系统淋巴瘤 (PCNSL) 的救援疗法具有挑战性. 大容量瘤 (>14毫升) 呈现局部衰竭的趋势,表明需要加强局部或全身治疗策略.
科学领域:
- 神经瘤学神经瘤学
- 临床瘤学临床瘤学
- 医疗成像医学成像
背景情况:
- 初级中枢神经系统淋巴瘤 (PCNSL) 的进展带来了重大挑战,救援疗法往往导致大量的发病率和死亡率.
- 了解第一个瘤进展的模式对于确定改善PCNSL治疗结果的机会至关重要.
研究的目的:
- 分析PCNSL患者第一个瘤进展的模式.
- 确定与局部控制 (LC) 和无进展生存 (PFS) 相关的患者,瘤和治疗变量.
主要方法:
- 连续95名病理确认PCNSL患者 (2002-2021) 的回顾性审查.
- 卡普兰-梅尔,日志等级测试和考克斯比例危险模型被用来评估影响LC,PFS的因素以及第一次失败的模式.
- 进行多变量和单变量分析来评估关联.
主要成果:
- 在队列中,一年的PFS为48%,一年的LC为80%.
- 在有进展的29名患者中,59%的患者只有局部性衰竭.
- 局部控制与年龄,卡诺夫斯基性能状态 (KPS),完成高剂量甲状腺素 (HD-MTX) 的>6个循环和通道内化疗有显著关联.
- 大容量瘤 (>14毫升) 倾向于增加局部第一次失败 (1年LC 64%vs83%<14毫升).
结论:
- 系统和内治疗对于实现PCNSL局部控制至关重要.
- 庞大的瘤中局部衰竭的趋势表明,可能需要加强局部疗法或加强全身治疗方法.
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