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目的 探讨原发于脑的多发性淋巴瘤诊治策略。方法 分析 1999年 9月～ 2 0 0 2年 6月收治 5例患者的诊治情况 ,均经病理证实为非霍奇金淋巴瘤 ,B细胞来源。所有病人均接受放、化疗综合治疗。结果 脑多发性淋巴瘤放射生物效应或放射敏感性不同。近期疗效良好。全组生存时间 8～ 4 8个月 ,1、3年生存率分别为 80 %和 2 5 %。其中 3例放疗 4 0～ 5 5Gy加 6周期化疗者分别生存 1～ 4年 ;另 2例放疗 6 0～ 75Gy加3～ 4周期化疗者分别生存 8～ 12个月。 4例治疗后 4～ 2 4个月复发 ,其中 2例出现脊髓侵犯。结论 脑多发性淋巴瘤易被误诊 ,三维立体定向穿刺活检 (定向活检 )可显著提高诊断效率。此病易复发 ,疗效不理想 ,伴脊髓侵犯者则更差。中等剂量放疗加足疗程化疗是有效的治疗方法 ,增加放射剂量未能改善肿瘤控制。放、化疗综合治疗可望提高疗效。
Objective To investigate the diagnosis and treatment strategy of multiple primary lymphoma in the brain. Methods The diagnosis and treatment of 5 patients admitted from September 1999 to June 2002 were all confirmed as non-Hodgkin’s lymphoma and B cell source by pathology. All patients received radiotherapy and chemotherapy combined treatment. Results Brain multiple lymphoma had different radiobiological effects or radiosensitivity. The recent good effect. The overall survival time of 8 to 48 months, 1, 3-year survival rates were 80% and 25%. Among them, 3 cases of radiotherapy 40 ~ 55Gy plus 6 cycles of chemotherapy were survival of 1 to 4 years; the other 2 cases of radiotherapy 6 0 ~ 75Gy plus 3 ~ 4 cycles of chemotherapy were survival of 8 to 12 months. 4 cases relapsed 4 ~ 24 months after treatment, of which 2 cases of spinal cord invasion. Conclusions Cerebral multiple lymphoma is easily misdiagnosed. Three-dimensional stereotactic biopsy (biopsy) can significantly improve the diagnostic efficiency. The disease is easy to relapse, the effect is not satisfactory, with spinal cord invaders are even worse. Moderate-dose radiation plus full-course chemotherapy is an effective treatment and increasing radiation dose fails to improve tumor control. Put radiotherapy and chemotherapy combined treatment is expected to improve the curative effect.