ACNU和三尖杉酯碱分别联合MTX超选择性脑动脉灌注治疗恶性脑瘤的疗效比较

A comparison of the effects of ACNU and MTX with harringtonine and MTX on malignant brain gliomas given by super selective endocerebrovascular infusions.

比较超选择性脑动脉灌注嘧啶亚硝脲（ＡＣＮＵ）加氨甲喋呤（ＭＴＸ）（Ａ组）以及三尖杉酯碱加ＭＴＸ（Ｂ组）治疗恶性脑胶质细胞瘤的疗效。方法将ＡＣＮＵ２～３ｍｇ／ｋｇ，三尖杉酯碱０１～０５ｍｇ／ｋｇ，ＭＴＸ０１～０２ｍｇ／ｋｇ按Ａ、Ｂ两组各１２例方案，采用超选择性脑动脉联合灌注化疗，并于化疗后１～１５个月以ＣＴ检查评定疗效。结果Ａ组肿瘤体积缩小４８３２％，Ｂ组缩小４６２１％；Ａ组有效者占４／１２，Ｂ组占３／１２；平均生存期分别为２５３个月和２３３个月；两组治疗前后肿瘤体积变化均有显著性差异，但两组疗效则无明显差异；并均无眼部及严重脑部并发症。结论ＡＣＮＵ加ＭＴＸ以及三尖杉酯碱加ＭＴＸ超选择性脑动脉灌注对恶性脑胶质细胞瘤的疗效相似，毒副作用小。

Objective The purpose of this study is to compare the therapeutic effects of ACNU plus MTX (group A) with harringtonine plus MTX (group B) on malignant brain glioma given by superselective infusion of intracerebral artery. Methods Dose of ACNU was 2-3 mg/kg, harringtonine 01-05 mg/kg, MTX 01-02 mg/kg given by superselective endocerebrovascular infusion. The patients with malignant brain gliomas were divided into group A and group B. The therapeutic effects were evaluated by CT scanning 1 to 1.5 months after chemotherapy. Results After the chemotherapy, the tumor sizes in group A and group B shrunk 48.32% and 46.21% respectively. The effective proportion of group A and group B were 4/12 and 3/12 separately. The mean survival time of group A and group B were 25.3 months and 23. 3 months separetely. In each group, there were apparent volume changes of the tumors before and after the chemotherapy. But no significant therapeutic difference has been found between the two groups. In each group, there were not any complications at the eyes and serious complications at the brain. Conclusions The therapeutic effects of ACNU plus MTX and harringtonine plus MTX given by supper selective endocerebrovascular infusion are similar and with minor toxic or side effects. 