大剂量MTX联合化疗及放射治疗非霍奇金淋巴瘤中枢神经系统侵犯Treatment of non-Hodgkin's lymphoma involved central nervous system lymphoma by combination of high dose methotrexate with several chemotherapic drugs followed by irradiation
程传耀,杨霄鹏,胡宁
摘要(Abstract)：
目的探讨大剂量MTX联合多药化疗方案治疗非霍奇金淋巴瘤(NHL)中枢神经系(CNS)侵犯的临床疗效。方法 1例经临床及实验室检查、CT、MRI及活检确诊为非霍奇金淋巴瘤中枢神经系侵犯患者,选择大剂量MTX、甲基卞肼、VCR、DXM联合化疗,2周方案,共3次,每周同步行鞘内注射化疗。结束后行局部脑立体定位及全脑预防放疗。每3个月原方案巩固化疗1次。结果化疗1周期后,患者头痛症状完全消失,病灶缩小>75%。3周期后,临床症状恢复,血象及脑脊液检查正常,MRI示病灶完全消失。随访至今病情稳定。结论多种透入血脑屏障化疗药物的联合应用,尤其大剂量MTX,能显著提高非霍奇金淋巴瘤中枢神经系侵犯的临床疗效。
关键词(KeyWords)： 非霍奇金淋巴瘤;中枢神经系统侵犯;大剂量MTX;脑立体定位放疗
基金项目(Foundation):
作者(Author): 程传耀,杨霄鹏,胡宁
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