南方医科大学学报2023，Vol.43Issue(4)：499-506,8.DOI:10.12122/j.issn.1673-4254.2023.04.01
原发性中枢神经系统淋巴瘤复发或进展模式的回顾性、单中心分析:是否可以替换全脑放疗?
A single-center, retrospective analysis of relapse and progression patterns of primary central nervous system lymphoma:can whole brain radiotherapy be replaced?
摘要
Abstract
Objective To analyze recurrence and progression patterns of primary central nervous system lymphoma (PCNSL) in patients without whole brain radiotherapy (WBRT) and assess the value of WBRT in PCNSL treatment. Methods This retrospective single-center study included 27 patients with PCNSL, who experienced recurrence/progression after achieving complete remission (CR), partial remission, or stable disease following initial treatments with chemotherapy but without WBRT. The patients were followed up regularly after the treatment for treatment efficacy assessment. By comparing the anatomical location of the lesions on magnetic resonance images (MRI) at the initial diagnosis and at recurrence/progression, we analyzed the patterns of relapse/progression in patients with different treatment responses and different initial status of the lesions. Results MRI data showed that in 16 (59.26％) of the 27 patients, recurrence/progression occurred in out-field area (outside the simulated clinical target volume [CTV]) but within the simulated WBRT target area in 16 (59.26％) patients, and within the CTV (in-field) in 11 (40.74％) patients. None of the patients had extracranial recurrence of the tumor. Of the 11 patients who achieved CR after the initial treatments, 9 (81.82％) had PCNSL recurrences in the out-field area but within WBRT target area;of the 13 patients with a single lesion at the initial treatment, 11 (84.62％) experienced PCNSL recurrence in the out-field area but within WBRT target area. Conclusions Systemic therapy combined with WBRT still remains the standard treatment for PCNSL patients, especially those who achieve CR after treatment or have a single initial lesion. Future prospective studies with larger sample sizes are needed to further explore the role of low-dose WBRT in PCNSL treatment.关键词
原发性中枢神经系统淋巴瘤/放射治疗/全脑放疗/复发/进展模式Key words
primary central nervous system lymphoma/radiation therapy/whole brain radiotherapy/recurrence/progression pattern引用本文复制引用
秦悦,刘蓉萍,张效楠,张湾,任陈,吴德华..原发性中枢神经系统淋巴瘤复发或进展模式的回顾性、单中心分析:是否可以替换全脑放疗?[J].南方医科大学学报,2023,43(4):499-506,8.基金项目
Supported by Guangzhou Science and Technology Project(202201011116)and National Natural Science Foundation of China(81972970).国家自然科学基金(81972970) （202201011116）
广州市科技计划项目(202201011116) （202201011116）
