X刀治疗胶质瘤的实验研究

The experimental study of X kinfe treatment of glioma

目的 胶质瘤的放射外科治疗作用存有争议 ,本研究采用大鼠C6胶质瘤模型 ,应用X刀系统对其进行了研究。方法 经CT检查选出适于X刀 5mm准直器治疗的 3～ 5mm瘤直径的大鼠46只进行了分组实验。X刀治疗剂量围绕临床定为 15、 2 0、 30及 40Gy。结果 治疗组动物平均生存期为 40 4天 ,对照组则为 2 3 5天 ,两组间有显著差异 (P <0 0 5 )。治疗组动物死后肿瘤直径平均在7 4± 2 1mm ,对照组则为 9 6± 0 6mm ,两组间亦有显著差异 (P <0 0 5 )。组织病理学 (光镜、电镜 )研究显示各组均表现为明显的细胞凋亡及坏死。结论 X刀治疗可使鼠脑胶质瘤有所缩小并可延长其生存期 ;

Objective Malignant gliomas represent nearly 45% intracranial tumors. Treatment of glioma continues to challenge neurosurgeons. Stereotactic radiosurgery (SRS) offers a new option in treating glioma. The understanding for its effectiveness remains to be determined. So we conducted this animal experiment and evaluated the role of X kinfe treatment of rat C6 glioma. Methods We used rat C6 glioma model via transplantation of the tumor cells to SD rat brain. We firstly try to use enhancement CT examination to confirm the onset of rat brain tumor and its response to SRS 61 rats were performed CT scan 12 25 days after implantation of tumor cells. 46 rats bearing 3 5mm diameter tumors were selected for grouping treatment by 5mm collimator of X knife. The control dose varied from 15,20, 30 to 40 Gy, corresponding to clinical treatment doses. Results 61 of 87 implanted animals occurred tumors. The inductive rate was 70 1%. The induced tumor reached to 2 6mm (mean 3 512±1 049mm) diameter at 12 18 days after transplantation and 3 7mm (mean 5 142±1 499mm) at 19 25 days. The treated animals had a mean survival of 40 375 days, while the control animals lived a mean of 23 5 days from tumor growth (P<0 05), indicating a direct cytotoxic response to treatment. Compared with tumors in control animals, no difference was identified in the amount of intratumoral hemorrhage under the processes of computer imaging handling system and SAS statistical system. The reault of CT scan of treated rats showed tumor disappearance in two 15Gy group animals, but instead of edema, and finally these two rats died identically to the animals of the other dose groups. Histological and ultrastructural analysis of SRS treated specimens revealed apoptosis and necrosis clearly. Conclusions The treating role of X knife is brought into play by apoptosis and necrosis these two ways. X knife treatment can prlong the survival time and can reduce the tumor size of the bearing tumor animals.