58例脑恶性胶质瘤术后放化疗疗效临床观察

Randomised control trial on use of adjuvant selective intra-arterial infusion ACNU on top of conformal radiotion therapy in 58 postoperative patients with malignant gliomas

目的观察脑恶性胶质瘤术后同步选择性动脉灌注尼莫司汀（ACNU）联合三维适形放疗与单纯三维适形放疗的疗效、生存率及安全性比较。方法治疗组为脑恶性胶质瘤28例经开颅显微手术后同步选择性动脉灌注ACNU联合三维适形放疗；对照组为脑恶性胶质瘤30例术后单纯三维适形放疗。结果同步放化疗组脑恶性胶质瘤治疗CR、PR高于对照组（P〈0．05），生存期也长于对照组（P〈0．05），其不良反应小、生存质量明显提高。结论显微手术后同步选择性动脉灌注ACNU联合适形放疗治疗脑恶性胶质瘤疗效较好，有望成为目前脑恶性胶质瘤的常规治疗方案之一。

Objective To compare the rate of short - term therapeutic effectiveness, survival duration and safety between patients receiving selective intra - arterial infusion ACNU combined conformal radiation therapy（CRT） and CRT alone in postoperative patients with malignant gliomas. Method 58 postoperative patients by initial operative treatment with malignant gliomas were randomly divided into two groups：selective intra- arterial infusion ACNU combined CRT （ACNU -CRT group）and CRT group. Results CR and PR of the ACNU - CRT group were higher than those of the CRT group. The results after a follow - up of 3 years indicated that the survival duration of the ACNU - CRT group was longer than that of the CRT group, and there was a statistically significant difference between the two groups （ P 〈 0. 05 ）. The main toxicities were not serious （grade Ⅰ - Ⅱ） and life quality of patients were improved. Conclusions Microsurgieal resection combined with selective intra- arterial infusion ACNU and CRT is a safe and effective method for malignant human brain gliomas.