Background: Primary lymphoma of the central nervous system (PCNSL) encompasses a variety of lymphoma subtypes, with the majority being diffuse large B-cell lymphomas, which require aggressive systemic treatment. In contrast, low-grade lymphomas are reported infrequently and are mostly limited to dural manifestations. Very rarely, parenchymal low-grade PCNSL is diagnosed, and the cases documented in the literature show a wide variety of treatment approaches. Methods: We screened all cases of PCNSL treated at our department (a tertiary hematooncology and neurooncology center) in the last 15 years and conducted a comprehensive literature research in the PubMed database. Results: Overall, two cases of low-grade primary parenchymal PCNSL treated with irradiation were identified. The dose prescriptions ranged from 30.6 to 36 Gy for the involved site, with sparing of the hippocampal structures. Both patients had an excellent response to the treatment with a mean follow-up of 20 months. No clinical or radiological signs of treatment toxicity were detected. Conclusions: Our analysis corroborates the results from the literature and demonstrates that parenchymal low-grade PCNSL shows a good response to localized radiation treatment, enabling a favorable outcome while avoiding long-term treatment toxicity.
背景：原发性中枢神经系统淋巴瘤（PCNSL）包含多种淋巴瘤亚型，其中绝大多数为弥漫性大B细胞淋巴瘤，需要积极的全身治疗。相比之下，低级别淋巴瘤的报道较为罕见，且多局限于硬脑膜表现。极少数情况下可诊断出脑实质低级别PCNSL，文献记载的病例显示出多样化的治疗方案。方法：我们筛查了本科室（三级血液肿瘤与神经肿瘤中心）近15年来收治的所有PCNSL病例，并在PubMed数据库中进行全面的文献检索。结果：共发现两例接受放射治疗的脑实质低级别PCNSL病例。靶区处方剂量范围为30.6至36 Gy，治疗期间均避开了海马结构。两名患者对治疗均表现出极佳反应，平均随访期为20个月。未发现临床或影像学上的治疗毒性迹象。结论：我们的分析证实了文献报道的结果，表明脑实质低级别PCNSL对局部放射治疗反应良好，在避免长期治疗毒性的同时能够获得良好预后。
肿瘤(癌症)患者之家