国际肿瘤学杂志››2019,Vol. 46››Issue (8): 505-508.doi:10.3760/cma.j.issn.1673-422X.2019.08.013

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原发性纵隔B细胞淋巴瘤治疗的研究进展

相明月1王丽丽2韩大力1

  1. 1山东省肿瘤防治研究院(山东省肿瘤医院)放疗科,betway必威登陆网址 (betway.com ),济南 250117;2山东省肿瘤防治研究院(山东省肿瘤医院)骨与软组织肿瘤外科,betway必威登陆网址 (betway.com ),济南 250117
  • 收稿日期:2019-03-20修回日期:2019-06-23出版日期:2019-08-08发布日期:2019-10-31
  • 通讯作者:韩大力 E-mail:dalihan_sdch@163.com
  • 作者简介:相明月和王丽丽对本文有同等贡献

Progress of treatment for primary mediastinal B-cell lymphoma

Xiang Mingyue1, Wang Lili2, Han Dali1

  1. 1Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy Medical Sciences, Jinan 250117, China;2Surgery of Bone and Soft Tissue Tumors, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy Medical Sciences, Jinan 250117, China
  • Received:2019-03-20Revised:2019-06-23Online:2019-08-08Published:2019-10-31
  • Contact:Han Dali E-mail:dalihan_sdch@163.com
  • About author:Xiang Mingyue and Wang Lili are contributed equally to this article

摘要:原发性纵隔B细胞淋巴瘤(PMBCL)是一种具有独特临床病理特征的侵袭性B细胞淋巴瘤。然而,在新的肿瘤分类模式下,R-CHOP是否能继续作为PMBCL的标准一线免疫化疗方案仍存在争议。DA-EPOCH-R与R-CHOP方案的疗效相当,但需注意药物的毒性反应。虽然PMBCL是一种放射敏感性的恶性肿瘤,但放疗并不作为PMBCL的常规治疗选择,免疫化疗后PET/CT仍阳性的患者需要活检证实以制定进一步治疗方案。复发/难治性PMBCL预后差,常采用挽救性免疫化疗,随后进行大剂量化疗和自体干细胞移植。复发/难治性PMBCL通常存在PD-1过表达,免疫检查点抑制剂潜在成为其重要的治疗方式。近年来,分子医学的发展为PMBCL靶点选择提供了新的依据,但有待进一步的临床试验证实。

关键词:淋巴瘤,B细胞,放射疗法,利妥昔单抗,化学疗法

Abstract:Primary mediastinal B-cell lymphoma (PMBCL) is aggressive Bcell lymphoma with unique clinicopathologic characteristics. However, under the new classification of PMBCL, whether R-CHOP was the standard first-line immunotherapy regimen remains a controversy. The DA-EPOCH-R is not inferior to R-CHOP, but attention should be paid to the toxic effects. PMBCL is a radiosensitive disease, but radiotherapy did not as the front-line therapy for PMBCL. A biopsy is required for positive PET/CT after immunotherapy-chemotherapy to determine the further treatment of PMBCL. Recurrent/refractory PMBCL, with poor prognosis, salvage immunochemotherapy is often used followed by high-dose chemotherapy and autologous stem cell transplant. PD-1 overexpression is common in recurrent/refractory PMBCL, and immune checkpoint inhibitors are potential to be an important treatment option. Recently, the development of molecular medicine has provided a new basis for the selection of targets in PMBCL, however, it needs to be further confirmed by clinical trials.

Key words:Lymphoma, B-cell,Radiotherapy,Rituximab,Chemotherapy