复发性胶质瘤经放疗囊近距离放疗临床研究

Radiation reservoir therapy system for brachytherapy of recurrent glioma

目的探讨复发性胶质瘤再次手术后,植入自制放疗囊系统对瘤床定期近距离放射治疗的效果。方法67例确诊复发性胶质瘤,手术切除肿瘤后,瘤床植入放疗囊系统。术后第7d经头皮穿刺注射131I30mCi行内放疗,每16d重复注入1次,4次1疗程,1个月后开始第2疗程,共1～2个疗程。结果术后6个月复查MRI,完全缓解(CR)13例;部分缓解(PR)21例;稳定(SD)18例;恶化(PD)15例;有效率50.1%。随访6～24个月,6个月存活率85.1%;1年存活率59.7%;2年存活率32.8%。结论术后残腔植入自制放疗囊系统对胶质瘤行定期近距离放疗符合抑制肿瘤生物学特性、简便易行、疗效较好的治疗方法。

Objective To explore the therapeutic effect of radiation reservoir therapy system for interstitial brachytherapy in patients with recurrent gliomas who underwent tumor resection. Methods Radiation reservoir therapy system was placed in the resection cavity at the time of tumor debulking in 67 recurrent glioma cases. ^131I （30mCi） was injected into the reservoir for brachytherapy on the 7 th day after the operation, which was repeated every 16 days for totally 4 times to complete one treatment course. The second course was initiated 1 month after the first course. Results MRI examination 6 months after treatment revealed complete remission in 13 cases, partial remission in 21 cases, stabilization in 18 cases, and progressive deterioration in 15 cases with an effective rate of 50. 1%. Follow-up for 6 to 24 months showed a survival rate of 6 months was 85.1%, 1 year 59.7% and 2 year 32.8%, respectively. Conclusion Radiation reservoir therapy system performs safely and efficiently. It delivers a readily quantifiable dose of radiation to the recurrent gliomas.