【摘要】 目的大剂量甲氨蝶呤(high-dose methotrexate,HD-MTX)联合利妥昔单抗(rituximab,R)与单用HDMTX治疗初发的原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)效果的评价。方法收集2012年1月1日至2015年12月31日在复旦大学附属华山医院就诊的初发PCNSL患者的临床资料,采用回顾性的队列研究,对于接受HD-MTX联合R及单用HD-MTX治疗的患者进行疗效和预后的生存分析。结果共有73例患者纳入研究,HD-MTX+R组38例,HD-MTX组35例。HD-MTX+R组患者的完全缓解(complete response,CR)率为84%,HD-MTX组患者的CR率为83%(P=0.878)。HD-MTX+R组患者的中位生存时间(overall survival,OS)为53个月,HD-MTX组患者的中位生存时间为27个月(P=0.047)。HD-MTX+R组患者的中位无进展生存期(progression-free survival,PFS)为44个月,HD-MTX组患者的中位无进展生存期为17个月(P=0.02)。两组患者两组的不良反应发生率差异无统计学意义。结论 HD-MTX+R组与HD-MTX组相比CR率相似,但是加用R有利于延长PCNSL患者的OS和PFS,且加用R不会增加不良反应。更多还原

【Abstract】 Objective To evaluate therapeutic effect of high-dose methotrexate(HD-MTX)combined with rituximab(R)compared with HD-MTX in patients with newly diagnosed primary central nervous system lymphomas(PCNSLs). Methods With a retrospective cohort,we collected the clinical data of patients with newly diagnosed PCNSL at Huashan Hospital of Fudan University since 2012 January 1to 2015 December 31.We analyzed the therapeutic effect and prognosis of the patients received HDMTX combined with R and HD-MTX. Results A total of 73 patients were identified,38 received HD-MTX+R,35 received HD-MTX.Complete response(CR)rates was 84%in the HD-MTX+R group and 83%in the HD-MTX group(P=0.878).Median overall survival(OS)was 53 months in the HD-MTX+R group and 27 months in the HD-MTX group(P=0.047).Median progression-free survival(PFS)was 44 months in the HD-MTX+R group and17 months in the HD-MTX group(P=0.020).The differences of incidence of adverse between the two groups had no statistical significance.Conclusions CR rate of HD-MTX+ R and HD-MTX cohorts is similar,meanwhile addition of rituximab to HD-MTX appears to improve OS and PFS without increasing adverse reactions in patients with newly diagnosed PCNSL.更多还原