博来霉素囊内应用治疗颅咽管瘤的初步探讨

Preliminary exploration of bleomycin applied intracysticly on craniopharyngiomas

目的 考察博莱霉素治疗颅咽管瘤的疗效、应用方式与副反应。方法 病人随机分成化疗、联合化放疗和放疗三组 ,经立体定向手术分别向囊内注入博莱霉素、博莱霉素与3 2 P以及3 2 P ,比较治疗前后瘤囊容积、症状以及血生化、内分泌指标、乳酸脱氢酶等变化。结果 随访除 2例外 ,所有瘤囊均有不同程度缩小。联合组 6例瘤囊完全消失 ,3例发生严重内分泌紊乱。所有患者血常规、肝肾功能及乳酸脱氢酶均无显著变化。结论 联合化放疗较单独博莱霉素囊内化疗和3 2 P囊内放疗疗效好 ,副反应也更重 。

Objective To explore the inhibitory effect, applied approach and relative complications of bleomycin on craniopharyngiomas. Methods Cystic craniopharyngiomas were randomly divided into chemotherapeutic group, combined chemo radiothepeutic group and radiotherapeutic group. Bleomycin, bleomycin mixed with 32 P, and 32 P were directly injected into the cysts from different groups after stereotactic operation. Both the cystic volumes before and after therapy and relative complications were reviewed,the index of the blood biochemistry, endocrinology and the lactate dehydrogenase were detected as well.Results During the follow up, all but 2 cysts regressed by different degree. 6 cysts from the combined therapeutic group disappeared completely, while 3 ones suffered severe endocrine complications in the same group. The blood routine, hepatic/renal function and lactate dehydrogenase with its isoenzymes of all cases didnt change significantly. Conclusions The therapeutic effect of combined chemoradiotherapy is better than the one of solitary chemotherapy or 32 P radiotherapy, but it may have more severe complications. It is suggested this chemoradiotherapy be adopted cautiously when all other treatments show no effect.