冷冻切除联合rhTNF-α治疗脑胶质瘤的临床观察

Treatment of brain gliomas by cryosurgery combined with rhTNF-α (report of 18 cases)

目的探讨冷冻切除联合重组人肿瘤坏死因子(rhTNF-α)治疗脑胶质瘤的效果。方法对18例脑胶质瘤患者采用冷冻切除联合rhTNF-α治疗。观察rhTNF-α毒副作用,出院前及以后每6个月复查一次MRI评估治疗效果。结果肿瘤全切除17例,1例次全切除。术前9例有病变对侧肢力减退者,均在1周内恢复。rhTNF-α常见的毒副作用为发热、局部红肿及肌肉疼痛等,发生率为38.9%(7/18)。术后随访6～20个月,除1例次全切者术后15个月死亡外,余17例均幸存。结论本结果提示冷冻切除联合rhTNF-α治疗脑胶质瘤可能成为胶质瘤治疗的一种新策略。

Objective To evaluate the therapeutical effect of cryosurgery combinated with recombinant human tumor necrosis factor α （rhTNF-α） on the brain gliomas. Methods The brain gliomas were removed by microsurgery after the cryosurgery and then were treated by intramuscular injection of rhTNF-α. The poisonous and side effects of rhTNF-α were observed in all the patients. MRI was performed before and per 6 month after the discharge from hospital in all the patients. Results Of 18 patients with brain gliomas, 17 underwent total resection of the tumors and 1 subtotal. The weakened muscle power in the limbs was recovered differently in degree in 9 patients whose muscle power in the limbs was weakened before the operation. The occurrent rate of the poisonous and side effects of rhTNF-α including fever, red and swollen region, bone and muscle pain and son on was 38.9%（7/18）. The following up showed that of 18 patients, 17 survived for more than 18 months and 1 who received subtotal resection of the tumor died 15 months after the treatment. Conclusion It is suggested that cryosurgery combinated with rhTNF-α may be a new method to treat the brain gliomas.