初级中枢神经系统淋巴瘤的结局和复发模式:从1983年到2020年诊断的559名患者的纵向分析
Kathryn R Tringale1,2, Michael Scordo3, Joachim Yahalom1
1Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Neuro-oncology
|June 25, 2024
概括
主要中枢神经系统淋巴瘤 (PCNSL) 复发模式显示远程,不可预测的复发后完整的反应. 耐药PCNSL患者面临局部复发的更高风险,指导优化多模式治疗.
科学领域:
- 神经瘤学神经瘤学
- 血液学 血液学 血液学
- 临床结果研究研究的临床结果.
背景情况:
- 主要中枢神经系统淋巴瘤 (PCNSL) 的当代结果和复发模式尚未明确.
- 分析了大量随访的大量队列,以确定与PCNSL复发相关的因素.
研究的目的:
- 描述初级中枢神经系统淋巴瘤当代结果和复发模式.
- 确定影响PCNSL患者复发的因素.
主要方法:
- 从1983年到2020年对免疫能力强的PCNSL (扩散大B细胞) 患者的分析.
- 根据诱导和巩固的反应分层,分类最初的复发地点.
- 评估无进展生存率 (PFS) 和整体生存率 (OS) 使用比例危险和累积发病率与局部复发的竞争风险.
主要成果:
- 559名患者的中位随访时间为7.4年;大多数患者具有特定的人口和疾病特征 (例如, supratentorial,多焦点参与).
- 实现完整反应 (CR/CRu) 的患者在巩固后的1年和5年的PFS分别为80%和46%,局部复发率低 (1.8%在1年).
- 耐药患者 (n=97) 的1年局部复发率 (57%) 与非局部复发率 (42%) 相比显著更高,与局部复发相关的深层结构参与.
结论:
- 这项研究为大型PCNSL队列提供了全面的复发模式.
- 完整反应后复发通常是遥远的和不可预测的.
- 耐药性PCNSL患者表现出局部复发的高发病率,这表明对这一高风险群体需要优化多模式治疗.
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