脑胶质瘤术后敏感药物间质化疗联合增敏放疗的临床分析

Clinical analysis of interstitial chemotherapy concurrent with sensitive radiotherapy for postoperative glioma patients

目的 :探讨脑胶质瘤术后敏感药物间质化疗联合增敏放疗的临床疗效。方法 :恶性脑胶质瘤 15 8例最大限度地全切或次全切 ,术中于瘤残腔内安置化疗囊 ,术后第 2 ,4,6,8周分别注射一次经MTT法筛选出的敏感疗药物ACNU ,BCNU ,VM2 6,DDP ,5 FU ,MMC ,ACR ,ADM和BLM中的一种 ,生理盐水 2～ 4mL稀释后穿刺化疗囊 ,微泵调控注射 6～ 8h。同时行全脑增敏放疗 ,2Gy/次 ,5次 /周 ,总量 5 5～ 60Gy。以后成倍延长间质化疗时间间隔。结果 :15 8例平均随访 3年 ,无明显不良反应 ,其中显效 (肿瘤完全消失 ) 46例 ,有效 (肿瘤部分消失 ) 78例 ,无变化 19例 ,恶化 15例。平均生存时间 66周 ,总有效率 78 5 %。结论

Objective To investigate the clinical effect of interstitial chemotherapy concurrent with sensitive radiotherapy for postoperative glioma patients.Methods At first, gliomal of 158 cases were resected totally or subtotally.One of all these ACNU, BCNU, VM-{26}, DDP,5 FU,MMC,ACR,ADM,BLM selected by method of MTT was diluted with 2～4 mL normal saline, and under the control of minimal pump,was injected into chemotherapy reservoir implanted under scalp for 6～8h in the 2nd, 4th, 6th, 8th week after operation, respectively. Concurrently volume dose of 55～60 Gy sensitive radiotherapy to whole brain was performed 5 times a week with 2 Gy each time. The following intervals of interstitial chemotherapy were doubly prolonged regularly.Results Among 158 patients with a median follow up time of 3 years with no server adverse effect, 46 cases displayed complete response, 78 cases showed partial response, 19 cases showed minor response, and 15 cases deteriorated. Mean survival time and general efficiency of interstitial chemotherapy concurrent with sensitive radiotherapy for the 158 postoperative glioma patients were 66 weeks and 78.5%, respectively. Conclusion Operation plus interstitial chemotherapy and concurrent with sensitive radiotherapy shows remarkable effect and safety in treating malignant glioma.;