Primary cerebral lymphomas: Unsolved issues regarding first-line treatment, follow-up, late neurological toxicity and treatment of relapses
Primary cerebral lymphomas: Unsolved issues regarding first-line treatment, follow-up, late neurological toxicity and treatment of relapses
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DOI：
10.1023/a:1008364612406
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发表时间：
2000-01-01
影响因子：
50.5
通讯作者：
Biron, P
中科院分区：
文献类型：
--
作者：
Blay, JY;Ongolo-Zogo, P;Biron, P
背景。免疫功能正常患者（PCL）的原发性脑非霍奇金淋巴瘤（NHL）仅位于中枢神经系统、眼睛或脑膜。这些患者的临床治疗仍有争议。患者和方法。截至1998年12月，对患者的临床特征和影响其结果的参数进行了调查，并在法国癌症中心联合会1980年至1995年期间接受治疗的226名患者的数据库中进行了登记。多数PCL为B型弥漫性大细胞NHL。在过去20年中，PCL的发病率在一些国家稳步上升，但不是所有国家。原发性脑淋巴瘤（PCL）患者的总生存率。中位数为12-16个月，5年生存率为5%-20%，这很糟糕。几个系列现已报道长期存活超过10年，因此PCL可能是一个可治愈的肿瘤的一些患者。PCL的最佳治疗方法尚不清楚。完全切除特纳并不能改善预后，多学科方法联合化疗和放疗不常用，尽管联合治疗优于放疗或单独化疗的优势从未在III期试验中得到证实。因此，最佳的化疗方案、剂量甚至化疗后脑放疗的有效性仍然是争论的焦点。最近，几位作者报道了PCL治疗后晚期神经系统后遗症的发生率相对较高。PCL患者的最佳治疗方法仍有待确定。不需要大型国际合作III期试验来确定和改进PCL的最佳治疗方法并减少其后遗症。
Background. Primary cerebral non-Hodgkin's lymphomas (NHL) in immunocompetent patients (PCL) are located exclusively in the central nervous system, the eye, or meninges. Clinical management of these patients remains controversial.Patients and methods. Clinical characteristics of the patients and parameters influencing their outcome as of December 1998 were investigated and registered in a database of 226 patients treated in the French Federation of Cancer Centers between 1980 and 1995.Results. Most PCL are diffuse large-cell NHL with a B phenotype. The incidence of PCL has been steadily increasing over the past 20 years in some but not all countries. The overall survival of primary cerebral lymphoma (PCL) patients in the published series. a median of 12-16 months and a five-year survival of 5%-20%, is poor. Several series have now reported long-term survivals of more than 10 rears and PCL may therefore be a curable tumor in some patients. The optimal treatment of PCL is not known. Complete resection of the turner does not improve outcome and multidisciplinary approaches combining chemotherapy and radiotherapy are non commonly used, although the superiority of combination over radiotherapy- or chemotherapy-alone has never been demonstrated in a phase III trial. The optimal chemotherapy regimen, the dose and even the usefulness of brain radiotherapy after chemotherapy are therefore still matters of debate. Recently, several authors have reported a relatively high incidence of late neurological sequelae after PCL treatment.Conclusions. The optimal treatment of PCL patients remains to be defined. Large cooperative international phase III trials are non required to define and improve the optimal treatment of PCL and reduce its sequelae.