冷冻切除联合5-氟尿嘧啶治疗脑胶质瘤

Treatment of Gliomas by Cryosurgery Combined with Chemotherapy

目的探讨冷冻切除联合5-氟尿嘧啶(5-FU)治疗脑胶质瘤的方法和效果。方法应用冷冻切除联合5-FU治疗位于大脑半球不同部位的脑胶质瘤26例,其中胶质母细胞瘤18例,间变性星形细胞瘤6例,恶性少枝胶质细胞瘤2例。肿瘤直径3.5～7.0 cm,平均约4.5 cm。-180℃冷冻肿瘤,持续时间为90 s,5 min后经静脉快速滴注5-FU(18mg/kg);再在显微镜下常规手术切除肿瘤,术后继续行5-FU(18 mg/kg)化疗10 d。结果肿瘤全切22例,次全切4例。21例有临床症状患者,术后症状2周内得以缓解或消失。对26例患者随访6～20个月,无1例死亡,MRI复查未见明显肿瘤复发。结论冷冻切除联合化疗对于脑胶质瘤能取得较好的治疗效果,然而该疗法作为胶质瘤又一治疗模式,其设备、技术的改进和发展及远期疗效尚需进一步研究。

Objective To study the method to treat of the gliomas by cryosurgery combined with chemotherapy and the curative of thw combined treatment effect on the gliomas. Methods Of 26 patients with cerebral hemisphere gliomas from 3.5 cm to 7,0 cm in diameter （mean, 4.5 cm）, 18 suffered from glioblastomas, 6 from anaplastic astracytomas and 2 from maglignant oligodendrogliomas. All the gliomas were frozen at -180℃ for 90 seconds. All the patients were treated by rapid venous infusion of 5- fluorouracil （5-FU） 5 minutes after the cryosurgery and then the gliomas were removed by microsurgery. All the patients were treated again by venous infusion of 5-FU for 10 days after the microsurgery. Results Of 26 cases of gliomas, 22 were totally removed and 4 subtotally. Twentyone patients with clinical symptoms were improved in clinical symptoms 2 weeks after the treatment. The following-up from 6 months to 20 months showed that no patients died and no recurrent gliomas were observed on MRI in all the patients. Conclusions The curative effect of cryosurgery combined with chemotherapy （5-FU） on the gliomas is good, but its long-term effect should be observed further. The instrument and technique of cryosurgery combined with chemotherapy should be improved.