弥漫性大B细胞淋巴瘤的放射治疗进展

doi:10.3969/j.issn.1000-8535.2024.09.002

摘要/Abstract

摘要： 弥漫性大B细胞淋巴瘤（DLBCL）是最常见的高度异质性非霍奇金淋巴瘤（NHL）,不同的疾病阶段或临床亚型预后不尽相同。放射治疗作为无交叉耐药的理想局部治疗技术,应用于DLBCL可有效改善患者预后。初治DLBCL通过放射治疗联合化学治疗、免疫治疗等综合治疗可使约60%~70%患者疾病缓解。对于不同预后影响因素,如年龄、肿瘤体积、淋巴结外侵犯等,联合放射治疗也可取得更佳疗效。在复发性/难治性DLBCL的治疗中,自体造血干细胞移植（ASCT）和嵌合抗原受体T细胞免疫治疗（CAR-T）是目前的研究热点,而放射治疗无论是作为ASCT与CAR-T术前的桥接治疗或失败后的挽救性治疗均有助改善患者预后。随着放射治疗技术的日益优化,放射治疗在综合治疗方案中扮演着越来越重要的角色。

关键词: 弥漫性大B细胞淋巴瘤, 放射治疗, 复发性/难治性弥漫性大B细胞淋巴瘤, 利妥昔单抗

Abstract: Diffuse large B-cell lymphoma（DLBCL）is a highly heterogeneous type of non-Hodgkin lymphoma（NHL）and its prognosis is different for different disease stages or clinical subtypes．Radiation therapy（RT）is a local treatment technique that does not cause cross-resistance and can effectively improve the prognosis of patients with DLBCL．When combined with chemotherapy and immunotherapy,RT can alleviate the disease in more than 60% of patients．Furthermore,RT can achieve better results for different prognostic factors such as age,tumor volume and external nodal invasion．For treating relapsed / refractory DLBCL,autologous stem cell transplantation（ASCT）and chimeric antigen receptor T cell immunotherapy（CAR-T）are currently being researched,while RT can help as bridging therapy before ASCT and CAR-T or salvage therapy after failure．With the increasing optimization of technology,radiotherapy plays an increasingly important role in combined treatment options．

Key words: diffuse large B-cell lymphoma, radiation therapy, relapsed / refractory DLBCL, rituximab

易泽新, 伍勇. 弥漫性大B细胞淋巴瘤的放射治疗进展[J]. 广州医药, 2024, 55(9): 974-984.

YI Zexin, WU Yong. Recent progress in radiation therapy for diffuse large B-cell lymphoma[J]. Guangzhou Medical Journal, 2024, 55(9): 974-984.

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