持续灌注榄香烯(elemene)治疗恶性脑肿瘤

Continuously Infused Elemene Chemotherapy in Treatment of Malignant Brain Tumors

目的：探讨持续灌注榄香烯治疗恶性脑肿瘤的疗效。方法：总结分析我院1996年1月～1998年11月间，采用持续灌注榄香烯化疗23例恶性脑肿瘤患者的疗效。恶性胶质瘤13例，脑转移瘤10例。榄香烯400～800mg／d，6～12g／疗程，2～3个疗程，每疗程间隔1～1．5个月。经皮颈内动脉穿刺插管，或经皮锁骨下静脉或肘正中静脉穿刺插管，用泵持续灌注。根据治疗前后肿瘤体积变化，平均生存期，体能状态评分评价疗效。结果：1）治疗前后肿瘤体积（cm3）平均缩小62．2％，P＜0．01。2）全组CR 3例，PR 14例，CR＋PR 17例，有效率73．9％（95％可信区间±13．4％）。对照组29例，CR 2例，PR 10例，CR＋PR 12例，有效率40．9％ （95％可信区间±17．9％）（P＜0．02）。3）治疗前后KPS平均记分差为6．5，P＜0．01。4）治疗组平均生存期25．8个月，对照组平均生存期17．4月（P＜0．01）。结论：持续灌注榄香烯化疗对恶性脑肿瘤疗效明显，能延长患者高质量的生存期，值得进一步探讨。

Objective： To discuss the effect of continuously infused elemene chemotherapy in malgnant brain tumors． Methods： From January 1996 to November 1998， 23 patients with malgnant brain tumors （13 primary brain tumors and 10 metastatic tumors） who underwent continuous infusion of elemene were studied retrospectively． A total dose of 400～800mg／d （6－12g for a therapeutic course） and 2～3 courses with an interval of 1～1．5 months were given． The drug was infused intravenously （via subclavical vein or intermedian cubital vein） or infused via carotid artery by a pump． The curative effect was observed by the change of tumor size， Karnofsky Performance Status and the survival time of the patient． Results： The mean decrease of tumor size （cm3） after treatment was 62．0％ （P＜0．02）． The CR and PR achieved in patients of the treatment group were 3 and 14 respectively． The overall effective rate was 74％ which was higher than that of the control group． The post－treatment mean increase of KPS was 6．5％ （P＜0．01）． The mean survival time of the treatment group was 25．8 months which was statisticly higher that of the control group （17．4 months） （P＜0．01）． Conclusion： Continuously infused elemene chemotherapy has significant effect in treatment of malgnant brain tumor． Patients can achieve prolonged and high quality survival time． Further investigation is worthwhile．