Stereotactic radiosurgery in the treatment of primary central nervous system lymphoma.
Stereotactic radiosurgery in the treatment of primary central nervous system lymphoma.
复制标题
DOI：
--
复制
发表时间：
2003-08
影响因子：
6.1
通讯作者：
Ya-fei Dong;L. Pan;Bin-jiang Wang;E. Wang;N. Zhang;P. Cai;J. Dai
中科院分区：
文献类型：
--
作者：
Ya-fei Dong;L. Pan;Bin-jiang Wang;E. Wang;N. Zhang;P. Cai;J. Dai
目的探讨伽玛刀放射外科(GKS)治疗原发性中枢神经系统淋巴瘤(PCNSL)的治疗方案及临床疗效。方法自1995年1月至2001年12月，对44例经立体定向活检或开颅手术并经病理确诊的PCNSL患者行GKS治疗。术后随访1~46个月，平均27个月。对其临床资料、影像特点、治疗方法及随访结果进行回顾分析。结果GKS术后1~3周，患者症状、体征明显改善。Kanofsky功能状态也从术前的平均40%改善到术后的90%。完全缓解(CR)38例(86.36%)，部分缓解(PR)6例(13.63%)。局部控制率达100%，中位生存期26.5个月。主要不良反应为脑水肿，可用地塞米松和甘露醇治疗。结论GKS是一种安全有效的综合治疗PCNSL的方法。立体定向活检联合GKS是诊断和治疗的首选方法。然后应根据患者的情况给予辅助化疗或放射治疗。
OBJECTIVE To explore the therapeutic alternatives and evaluate the related clinical results of patients with primary central nervous system lymphoma (PCNSL) treated with gamma knife radiosurgery (GKS). METHODS From January 1995 to December 2001, 44 patients suffering from PCNSL, who had undergone stereotactic biopsy or craniotomy, and who had received a confirmed diagnosis through pathological examination, were treated with GKS. All cases were followed up for 1 - 46 months with an average postoperative period of 27 months. The clinical materials, image features, treatment methods and results of follow-up, were retrospectively reviewed. RESULTS The symptoms and signs of the patients were markedly improved within 1 - 3 weeks after GKS. The Kanofsky performance status was also improved from a preoperative average of 40% to a postoperative one of 90%. Thirty-eight patients (86.36%) were in complete remission (CR), the other six (13.63%) were in partial remission (PR). The local control rate reached 100%, and the median survival time was 26.5 months. The main side effect was brain edema, which can be treated with dexamethasone and mannitol. CONCLUSION GKS is a safe and effective method in multimodality treatment of PCNSL. A stereotactic biopsy coupled with GKS is the first choice for diagnosis and treatment. Adjuvant chemotherapy or radiotherapy should then be given according to the patient's condition.