高压氧联合放化疗综合治疗原发性中枢神经系统淋巴瘤.DOCVIP

临床医学论文-高压氧联合放化疗综合治疗原发性中枢神经系统淋巴瘤 ?????????????????? 作者：付廷刚 王艳芝 徐厚池 刘学健??????? 【关键词】? 高压氧 ??? 摘要：目的：研究高压氧联合化、放疗治疗原发性中枢神经系统淋巴瘤（PCNSL）的疗效，探索临床治疗PCNSL的新方案。方法：随机选取经手术和病理证实的PCNSL15例为对照组，17例为治疗组；对照组术后给予化、放疗治疗，治疗组在此基础上加用高压氧治疗。对两组总有效率、中位生存期、生存率及副作用发生率进行比较。结果: 对照组、治疗组总有效率分别为80%、94.1%，中位生存期分别为28.6个月、39.6个月，1、2、3、5年生存率分别是73.3%、46.7%、33.3%、20%和88.2%、64.7%、47.1%、35.3%。神经毒性等放化疗副作用发生率分别为46.7%、17.6%。两组比较有显著差异。结论：高压氧联合化、放疗综合治疗可显著提高PCNSL的疗效，降低放化疗副作用。 ??? 关键词：淋巴瘤；中枢神经系统；高压氧；化疗 ??? Treatment of Primary Central Nervous System Lymphoma (PCNSL) in Combination of Hyperbaric Oxygenation (HBO) with Chemotherapy Followed by Radiotherapy ????? Abstract： Objective： To study the efficacy of HBO in combination with chemotherapy followed by radiotherapy for treatment of PCNSL and to explore a new clinical therapeutic approach for PCNSL. Method： To select 15 cases of PCNSL verified by operational and pathological diagnosis as control, and treat them with chemotherapy and radiotherapy; to select 17 other patients treated with HBO in combination with the above therapies, then to compare the comprehensive effects and side effects between the two groups. Result： The total efficacies of the control group and the HBO group are 80% and 94.1% respectively, and the inside survival period are 28.6 months and 39.6 months, the survival rates of 1, 2, 3 and 5 years are 73.3%、46.7%、33.3%、20% and 88.2%、64.7%、47.1%、35.3%.Therefore, there are obvious differences between the two groups.(p0.05). Conclusion： Treatment of PCNSL patients with HBO can improve the curative effects of chemotherapy and radiotherapy and decrease the side effects. ??? Key words：Lymphoma；Central nervous system；Hyperbaric oxygenation；Chemotherapy ??? 原发性中枢神经系统淋巴瘤（PCNSL）是临床少见的恶性肿瘤；由于其病理生理学特性，治疗原则和其他中枢系统肿瘤不同；随着近年来发病率的明显增高，对其认识逐渐增多和明朗，但疗效不尽理想。我们自1998年至2004年12月采用术后高压氧联合化、放疗治疗PCNSL17例，效果明显，现总结报告如下： ??? 1资料与方法 ??? 1.1临床资料：对照组15例/治疗组17例，共32例。男10例/11例，女5例/6例；年龄5～68岁/4～70岁，平均44.3岁/44.8岁。肿瘤部位：颈髓1例/1例，颅内14例/16例；颅内单发9例/9例，多发5例/7例；其中损害单个脑叶7例/8例；位于大脑深部5例/7例，