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,山东第一医科大学(山东省医学科学院),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,山东第一医科大学(山东省医学科学院),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:2019-03-20 Revised:2019-06-23 Online:2019-08-08 Published: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