手术切除联合间质内缓释化疗治疗复发性脑胶质瘤

Treatment of recurrent malignant brain gliomas by surgical excision combined with biodegradable polymers of interstitial chemotherapy

目的 探讨外科手术切除与瘤床间质内缓释化疗治疗复发性脑胶质瘤的疗效。方法对 3 0例复发性恶性脑胶质瘤患者行开颅手术全切除 ,术中在瘤床植入Vp 16多聚缓释体 ,用量为 10 0～150mg。随访 3～ 2 4个月 ,观察肿瘤再次复发率和患者死亡率 ,并与以前随访的 46例再次手术的恶性脑胶质瘤结果相对比。结果 3 0例患者均获随访 ,3个月复发 5例 (16.7% ) ,死亡 2例 (6.7% ) ;6个月复发 9例 (3 0 .0 % ) ,死亡 6例 (2 0 .0 % ) ;12个月复发 15例 (50 .0 % ) ,死亡 12例 (40 .0 % ) ;2 4个月复发 2 5例 (83 .3 % ) ,死亡 2 1例 (70 .0 % ) ;全部患者均无化疗不良反应。结论 力争手术全切除联合瘤床间质内缓释化疗 ,可提高药物在瘤灶处的浓度和作用时间 。

Objective To investigate the effectiveness of treatment of recurre nt malignant brain gliomas by surgical excision combined with biodegradable poly mers of interstitial chemotherapy. Methods In 30 patients with recurrent malign ant brain gliomas, the tumor was surgically removed and Vp-16 biodegradable poly mers were implanted during operation in the tumor bed at a dose of 100～150 mg. T he patients were followed up for 3～24 months, and the results were compared wit h 46 cases with the recurrent malignant brain gliomas who received operation only . Results At 3, 6, 12, 24 months after treatment, the recurrent rate was 16.7%, 30%, 50% and 83.3%, respectively; the mortality rate was 6.67%, 20%, 40% and 70% , respectively. All the patients had no apparent side-effects of chemotherapy. Conclusion Surgical treatment combined with interstitial chemotherapy with bio degradable Vp-16 polymers improves the treatment result of recurrent malignant brain gliomas compared to surgery alone