원발성 중추신경계 임파종 환자에서 방사선-항암복합요법 시행의 단기치료경과
Preirradiation Methotrexate, Radiation Therapy and Cytosine Arabinoside Chemotherapy in Primary Central Nervous System Lymphoma ; Short-term Results
소속 상세정보
이상구
남도현/조병문/이정일/김종수/홍승철/신형진/박관/어환
KMID : 0359819990280091324
Abstract
결론
본 저자들은 1995년 1월부터 1998년 5월까지 약 3년간 조직학적으로 확진된 원발성 중추
신경계 임파종환자에 있어 방사선-항암 복합요법을 적용한 결과 다음과 같은 결론을 얻을
수 있었다.
1) 복합요법을 마친 환자는 방사선학적 및 임상적 호전을 보이고 비교적 좋은 반응정도
(favorable response rate)를 나타내었다.
2) 정맥내 및 척수강내 고농도의 MTX투여로 조기관해를 얻을 수 있었으며, 이는 전척수
방사선치료를 우회할 수 있을 것으로 사료된다.
3) 전신적 합병증 및 이로 인한 사망이 있을 수 있으므로 계속적인 추적관찰이 요구된다.
비록 치료과정을 모두 끝낸 환자수가 적고 짧은 추적기간이어서 생존률 및 중간생존기간,
재발환자의 예후등에 대해 언급하지는 않았지만 앞으로 장기간의 추적관찰이 더 필요할 것
으로 생각된다.
#초록#
Purpose : Primary CNS lymphoma(PCNSL) is a rare brain tumor which has poor
prognosis. It is sensitive to steroid or radiation therapy(RT), but the effect is transient.
Recently. many centers have tried to increase survival rats and to lower recurrence rate
by combined chemotherapy. Aim of this study is to investigate the response rate.
performance status change and complications after combined modality treatment in our
patien with PCNSL.
Patients and Methods : Fifteen consecutive PCNSL patients were included in this
study. There was no immune compromized patient. All patients underwent pre-radiation
systemic MTX, 1g/㎡, plus 6 doses of intrathecal MTX at 12㎎ per dose. Cranial
RT(WBRT 40 Gy, Boost 14.4 Gy) was followed by two cycles of intravenous infusion
of high dose cytarabine(Ara-C). We reviewed medical accords, radiologic findings for
evaluation of response and performance status.
Results : Seven patients completed this protocol. Response rate(CR+PR/total) after
radiation and alter completion of combined modality were 80% and 87% respectively. No
patients showed the decrease in performance status 90 more than pre-treatment status
during treatment. Four CSF cytology positive patients had undergone all negative
conversion after completion of intrathecal MTX chemotherapy.
Conclusion : The addition of chemotherapy to cranial RT for initial treatment of
PCNSL had favorable response rate. CSF cytology negative conversion rate, and
maintaining performance status. But, we also have observed treatment failure including
lifts threatening complications and non-responder. Therfore, careful monitoring of medical
status should warranted and neuropsychological functions should also be evaluated.
Primary CNS lymphoma; Chemotherapy; Radiation therapy; Response rate; Complication; Karnofsky performance scale;
키워드
원문 및 링크아웃 정보
등재저널 정보