脑恶性胶质瘤自体瘤苗治疗的临床初步观察

Preliminary Results of Immunotherapy Against Malignant Gliomas Using Autologous Tumor Cell Vaccine

背景与目的 :探讨NDV(新城鸡瘟病毒)修饰的瘤苗治疗脑恶性胶质瘤的疗效。 材料与方法 :自2001_05～2001_11,对8例恶性脑胶质瘤患者给予瘤苗免疫治疗。显微镜下行肿瘤全切除或次全切除 ,术中留取肿瘤组织备用瘤苗制作和药敏试验 ;切口愈合后即行放疗 ;放疗结束后 ,根据药敏试验结果行化疗一疗程 ;化疗后4周 ,行瘤苗治疗 ,每周注射一次共4次为一疗程。 结果 :通过门诊复查、随访10～25个月。4例无复发 ,KPS90～100分 ,生存期分别为25、24、20、23个月 ,平均23个月。复发4例 ,其中3例死亡 ,生存期分别为10、14、15个月 ,1例右额胶质瘤III级者全切除术后13个月复发 ,行γ刀治疗及化疗 ,现KPS90分 ,已生存19个月 ,该疗法超过文献中脑恶性胶质瘤中位生存期不足一年的报告。 结论 :恶性脑胶质瘤自体瘤苗治疗理论上可以提高机体的免疫力 ,预防肿瘤复发 ,但还需临床和基础的进一步研究 。

BACKGROUND AND AIM: To evaluate the therapeutical effect of autologous Newcastle_Disease_Virus(NDV)modified tumor cell vaccine in the treatment of malignant gliomas. MATERIAL AND METHODS: Eight patients with malignant gliomas were treated with autologous NDV_Modified tumor cell vaccine from May to November of2001.The tumor was total or sub_total resected under neuromicroscope and the tumor tissues were preserved for vaccine preparation and drug sensitive test.All the patients received postoperative radiotherapy followed by one cycle of chemotherapy.Four weeks after chemotherapy,the patients were immunized with tumor vaccines once a week for four weeks. RESULTS: All the patients were followed up from10to25months by June of2003.Four patients survived without the evidence of recurrence with the Karnofsky Performance Scale(KPS)from90to100,and the survival time was25,24,20and23months,respectively(mean23months).Four cases recurred,and three of them died in the10th,14th,15th month after the treatment,respectively.One patient with frontal glioma of Grade III recurred within13months after resection.The patient was treated with gamma_knife radiosurgery and chemotherapy and still alive up to19months follow_up end.The mean survival time in this therapy was more than one in documents,which was less1year for the patients with malignant glionas. CONCLUSIONS: Autologous modˉified tumor cell vaccines for treatment of malignant gliomas may be a promising alternative to enhance patients'immunity and prevent the recurrence of gliomas,however,its efficiency need to be immproved.