应用干扰素α-2b瘤内化疗治疗颅咽管瘤的临床观察

Clinical observation of interferon α-2b in intratumoral chemotherapy for craniopharyngiomas

目的评估瘤内应用干扰素α-2b治疗颅咽管瘤的疗效与副作用。方法回顾性分析82例囊性或囊性为主颅咽管瘤病例资料。病人均接受立体定向Ommaya囊植入术,并通过其进行瘤内化疗。每周期化疗结束后间断通过头颅CT和(或)MRI检查计算肿瘤体积来评估疗效,根据疗效判断是否需要再次化疗。结果影像学显示病变对治疗出现完全反应63例,部分反应16例,轻微反应3例。副作用轻微且可耐受,包括发热、头痛、疲劳、关节痛、眼睑水肿、短暂低钠血症、食欲不振和体重下降,无病人因副作用而中断治疗。未见新发内分泌缺陷者,治疗及随访期间无病人死亡。结论干扰素α-2b是一种可有效控制囊性或囊性为主的颅咽管瘤,且为副作用与治疗风险均较小的瘤内治疗用药。干扰素α-2b作为一种新的治疗选择,进一步应将治疗策略标准化并临床推广。

Objective To evaluate the efficacy and side effects of intratumoral interferonα-2 b based chemotherapy for craniopharyngioma.Methods Clinical data of 82 patients with cystic craniopharyngiomas and predominantly cystic tumors were analyzed retrospectively.All of the patients were placed an intracystic catheter connected to a subcutaneous Ommaya reservoir with the help of stereotactic technique.And then,the catheter was applied in the intratumoral chemotherapy.The curative effect of treatment was assessed by calculating the tumor volume regularly on CT and or MRI after the end of cycle chemotherapy.And the cycle may be repeated depending on response.Results Radiological studies demonstrated a changeable response to treatment in all patients with craniopharyngiomas(complete response in 63,partial response in 16 and minor response in 3).Some slight and tolerable side effects were observed,including fever,headache,fatigue,arthralgia,eyelid edema,transient hyponatremia,appetite loss and weight loss,but these were not enough to terminate the treatment.New endocrinological deficits were not observed in the cohort.There was no mortality during treatment and follow-up period.Conclusions Interferonα-2 b is an effective intratumoral drug in the control of cystic or predominantly cystic craniopharyngiomas.In addition,it is also the intratumoral drug with less side effects and more benefit risk ratio.As a novel and reliable treatment option,it is worthy of making treatment strategies standardized and promoting further.