摘要
目的：由影像表现结合临床制定定向活检、手术选择联合治疗方案。方法：回顾1999—2003年6组原发性脑淋巴瘤（PLB）101例进行临床分析，以MR、CT表现病灶部位分布为基础，制定可供活检、手术切除、联合治疗选择的五种类型。结果：Ⅰ型：大脑半球浅部、皮质下单发型；手术切除＋放疗、化疗。Ⅱ型：大脑半球深部单发型（中线、侧脑室壁、基底核区）；定向活检／酌情手术＋放疗、化疗。Ⅲ型：小脑单发型（含小脑脑桥角．CPA）；手术切徐除＋放疗、化疗。Ⅳ型：大脑半球多发型；定向活检＋放疗、化疗。Ⅴ型：小脑幕上下弥散型（舍脑表面、脑干）；定向活检／脑脊液（CSF）瘤细胞检查＋放疗、化疗。结论：按分型结合病人状态选择定向活检、手术切除、放疗（包括γ刀、x刀治疗）、化疗联合方案。强调定向活检提高诊断率，权衡利弊实施联合治疗、规范施行化疗方案，观察研究改善给药方法提高药效；对国内可诱发PLB危险人群发病要引起关注研究。
Objective： To work out a combined treatment plan of surgery and oriented biopsy which based on expression of images. Methods：To analyse 101 cases of primary lymphoma of the brain （ PLB）, which range from 1999 to 2003 ,five types cases that could be taken by biopsy, surgical intervention and combined treatment were classified based on its image materials. Results： Ⅰ type： solitary tumor that was located on superficial and subcortical cerebral hemisphere, these cases could be treated by surgical intervention plus radiotherapy and chemotherapy. Ⅱ type ： solitary tumor which was located on deep parts of cerebral hemisphere （ the median line, the walls of lateral ventricle, basal nuclei） , these cases could be treated by oriented biopsy or surgery plus radiotherapy and chemotherapy. Ⅲ type： Solitary tumor in cerebellum （including CPA） which could be treated by surgical intervention plus radiotherapy and chemotherapy. Ⅳ type： multiple tumors in cerebral hemisphere which could be treated by oriented biopsy plus radiotherapy and chemotherapy. Ⅴ type： diffuse type superior and inferior the tcntorium（ including the surface of brain and brain stem ） which could be treated by oriented biopsy or cytological examination of CSF plus radiotherapy and chemotherapy. Conclusion：The combined treatment plan of oriented biopsy, surgical intervention, radiotherapy and chemotherapy should be work out based on type and patient＇s situation. We should emphasize the combined treatment after weighing advantages and disadvantages while should not obviate the surgery with exception. The chemotherapy should be regularized, and the ways of medication must be observed and studied so as to increase the curative effect. The civil crowd of exposure, which could be evoked PLB should be mentioned and explored.
出处
《内蒙古医学院学报》
2006年第5期417-421,共5页
Acta Academiae Medicinae Neimongol
