Stereotactic radiosurgery in the treatment of primary central nervous system lymphoma

摘要

Objective To explore the therapeutic alternatives and evaluate the related clinical results, of patients with primary central nervous system lymphoma ( PCNSL) treated with gamma knife radiosurgery (GKS). Methods From January 1995 to December 2001, 44 patients suffering from PCNSL, who had undergone stereotactic biopsy or craniotomy, and who had received a confirmed dignosis through pathological examination, were treated with GKS. All cases were followed up for 1 ― 46 months with an average postoperative period of 27 months. The clinical materials, image features, treatment methods and results of follow-up, were retrospectively reviewed. Results The symptoms and signs of the patients were markedly improved within 1 ― 3 weeks after GKS. The Kanofsky performance status was also improved from a preoperative average of 40% to a postoperative one of 90%. Thiry-eight patients (86. 36%) were in complete remission (CR), the other six (13. 63%) were in partial remission (PR). The local control rate reached 100%, and the median survival time was 26. 5 months. The main side effect was brain edema, which can be treated with dexamethasone and mannitol. Conclusion GKS is a safe and effective method in multimodality treatment of PCNSL. A stereotactic biopsy coupled with GKS is the first choice for diagnosis and treatment. Adjuvant chemotherapy or radiotherapy should then be given according to the patient' s condition.