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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Multi-modality therapy leads to longer survival in primary central nervous system lymphoma patients.
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Multi-modality therapy leads to longer survival in primary central nervous system lymphoma patients.

机译：多模式疗法可延长原发性中枢神经系统淋巴瘤患者的生存期。

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BACKGROUND: Primary central nervous system lymphoma (PCL) is more frequently encountered by neurosurgeons given the increasing incidence among both nonimmunocompromised and immunocompromised patients. The most frequent surgery is stereotactic biopsy. Historically, radiation therapy has been the standard treatment modality for this disease and median survival was in the 15-month range. More recently, multi-modality therapy combining radiation therapy with chemotherapy (systemic, intrathecal, and/or intra-arterial) have resulted in longer survivals. We reviewed survival data for our series of patients treated for PCL over the last decade. METHODS: Thirty-four patients with histologically confirmed PCL were treated at our center. Multivariate Cox regression analysis was performed to determine which factor(s) (age, gender, HIV status, Karnofsky Performance Scale, chemotherapy, single modality therapy, histology, location, number of lesions, surgical resection) had a significant impact on survival. RESULTS: The overall median survival was 19 months. Patients receiving multi-modality therapy (n=17) (chemotherapy and radiation) had a median survival of 34 months compared to four months for patients receiving single modality therapy (n=17 including seven HIV positive patients). Multi-modality therapy was the only significant factor affecting survival in this multivariate analysis (p<0.0001). CONCLUSIONS: Chemotherapy plus radiotherapy significantly enhances survival over patients treated with single modality therapy alone. Quality of life issues should be addressed on a case by case basis as additional treatment modalities are initiated.
机译：背景：鉴于非免疫功能低下和免疫功能低下患者的发病率不断上升，神经外科医生更常遇到原发性中枢神经系统淋巴瘤（PCL）。最常见的手术是立体定向活检。从历史上看，放射疗法一直是该疾病的标准治疗方式，中位生存期为15个月。最近，将放射疗法与化学疗法（全身性，鞘内和/或动脉内）相结合的多模式疗法已导致更长的生存期。我们回顾了过去十年中接受PCL治疗的一系列患者的生存数据。方法：我们中心对34例经组织学证实为PCL的患者进行了治疗。进行了多变量Cox回归分析，以确定哪些因素（存活率，年龄，性别，HIV状况，卡诺夫斯基绩效量表，化学疗法，单模治疗，组织学，位置，病变数目，手术切除）对生存率有重要影响。结果：总体中位生存期为19个月。接受多种疗法（n = 17）（化学疗法和放射疗法）的患者中位生存期为34个月，而接受单一疗法的患者为4个月（n = 17，包括7名HIV阳性患者）。在这种多变量分析中，多模式疗法是影响生存率的唯一重要因素（p <0.0001）。结论：化学疗法加放疗可显着提高单药治疗的生存率。在启动其他治疗方式时，应逐案解决生活质量问题。

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