超选择性脑动脉灌注替尼泊甙并卡氮芥静滴治疗恶性脑瘤

The clinical study on effect of superselective intracranial arterial infusion of VM26 and BCNU on brain malignant tumor.

目的观察超选择性脑动脉灌注替尼泊甙（ＶＭ２６）并卡氮芥（ＢＣＮＵ）静滴治疗恶性脑瘤的临床疗效。方法对４７例脑瘤于手术切除后，采用超选择性脑动脉灌注ＶＭ２６并ＢＣＮＵ静滴，于化疗后６个月分别用ＣＴ检查肿瘤体积变化及评价临床症状，并与化疗前比较。结果本组化疗前肿瘤平均体积为（１６．１５±６．８８）ｃｍ３，化疗后平均体积为（８．８９±１１．４２）ｃｍ３（Ｐ＜０．０１），总有效率为７２３％（３４／４７）（完全缓解率为２１．３％），稳定不变１０．６％（５／４７），恶化占１２．７％（６／４７）。本组病例１年存活率达８５．１％（４０／４７），２年存活率为７０．２％（３３／４７），全部患者均无眼部症状及严重的神经副反应。结论认为超选择性脑动脉联合化疗的方法，存活率较单纯颈内动脉灌注化疗及外周静脉化疗高，而且并发症少，全身反应轻。

Objective To study clinical effects of superselective intracranial arterial infusion of VM26 and BCNU ivd on brain malignant tumor. Methods 47 of patients with brain malignant tumor were treated by superselective intracranial arterial infusion of VM26 and BCNUivd after the operations. Six months after chemotherapy, CT scan was implemented and clinical symptom was evaluated. Results Average volume of tumor before chemotherapy was(16.15±6.88)cm3, average volume of tumor after chemotherapy was (8.89±11.42)cm3 (P<0.01), total response rate was 72.3% (with complete remission rate of 21.2%), unchanged rate 10.6% and worsen rate 12.7%. The survival rate of the first year was 85.1%, the survival rate of two years was 70.2%. There was no symptom of neurotoxicity and vision decrease. Conclusions The results showed that the survival rate of the patients treated by superselective intracranial arterial infusion of VM26 and BCNU ivd were higher than by carotid internal arterial infusion and intravenous chemotherapy. 