经颈动脉灌注ACNU、VM-26联合治疗复发性脑胶质瘤的临床研究

目的研究经颈动脉灌注盐酸尼莫司汀(ACNU)和替尼泊苷(VM-26)联合治疗复发性脑胶质瘤的效果及相关问题。方法治疗组选择幕上颈内动脉供血范围的复发性脑胶质瘤164例,肿瘤同侧颈总动脉ACNU和VM-26联合灌注化疗。对照组选择复发性脑胶质瘤26例,口服司莫司汀治疗,并行疗效对比。结果治疗组完全缓解率和部分缓解率明显高于对照组(P<0.05),恶化率明显低于对照组(P<0.05),生存期明显长于对照组(P<0.05)。结论经颈动脉灌注ACNU、VM-26治疗复发性脑胶质瘤疗效好,副作用小,安全可靠,可作为常规化疗手段。

经颈动脉灌注尼莫司汀和依托泊苷治疗脑恶性胶质瘤164例

目的评价经颈动脉灌注尼莫司汀(ACNU)+依托泊苷(VM-26)联合对复发性脑胶质瘤的疗效及安全性。方法治疗组为幕上颈内动脉供血范围的复发性脑胶质瘤164例,肿瘤同侧颈总动脉ACNU、VM-26联合灌注化疗。对照组为复发性脑胶质瘤26例,口服司莫司汀(CCNU)治疗结果颈动脉灌注治疗的CR、PR高于对照组(P<0.05);生存期也长于对照组(P<0.05)。结论。经颈动脉灌注ACNU、VM-26治疗复发性脑胶质瘤疗效高,副作用小,安全可靠,可作为常规化疗手段。

经颈动脉颅内化疗并放疗治疗脑转移瘤17例体会

多数转移性脑肿瘤治疗较棘手,多已不易或不宜手术,而常规静脉化疗绝大多数药物又不能透过血脑屏障。为探索提高转移性脑瘤疗效的方法,笔者于1995年9月至1998年9月,采用颈动脉穿刺灌注颅内化疗和/或静脉化疗,并脑部放疗的方法治疗转移性脑肿瘤17例,收到了较好的临床效果。

立体定向放射外科加血脑屏障开放化疗治疗脑深部胶质瘤

目的 研究和评价应用立体定向放射外科加血脑屏障开放、颈动脉灌注化疗治疗脑深部和重要功能区胶质瘤 (GDEBA)。方法 对 5 0例患者进行治疗 ,肿瘤体积 19.72cm3 ～ 135 .5 6cm3 ,平均 43.2 8cm3 ,先行X 刀治疗 ,术后 3～ 7天行血脑屏障开放、颈动脉卡铂灌注 (40 0mg/次 ) ,4周后重复化疗。结果 随访 3月～ 2 .7年 ,显示2 4例 (48%)肿瘤消失 ,14例 (2 8%)缩小 ,6例 (12 %)保持稳定。 6例 (12 %)肿瘤再生长。在随访超过 2年的患者中 ,存活率为 72 .7%。死亡 5例 (10 %)。结论 采用X 刀加BBB开放、颈动脉灌注化疗治疗GDEBA是一种微侵袭和风险小的方法 ,能够延长病人生命 ,改善生存质量和预后。

Effect of intraarterial chemotherapy on vascular endothelial growth factor expression and microvessel density in carcinoma of the cervix

Objective: To clarify the effect of intraarterial chemotherapy on vascular endothelial growth factor (VEGF) expres- sion and microvessel density (MVD) count in carcinoma of the cervix. Methods: Before intraarterial chemotherapy and after 2–3 weeks of therapy, the expression of VEGF and MVD count in 36 carcinoma tissues of locally advanced cervical cancer were determined by CD34. Results: Before intraarterial chemotherapy and after 2–3 weeks, the expression of VEGF were 75% (27/36) and 30.6% (11/36) respectively, and MVD were reduced obviously (P<0.001). Conclusion:?The intraarterial chemotherapy can reduce the expression of VEGF and MVD, and adjust malignancy of cervical cancer, and cut down the postoperative metastasis.

Analysis of the Curative Effect of Preoperative Intra-Arterial Infusion Chemoembolization on Stage IB2-IIB Uterine Cervix Cancer

OBJECTIVETo investigate the short-term and long-termtherapeutic efficacy of preoperative intra-arterial infusion chemo-embolization on stage IB_2-IIB uterine cervix cancer (UCC).METHODS A total of 143 patients with Stage IB_2-IIB UCCwere divided into a clinical trial group and a control group.Thepatients in the clinical trial group(n=86)were treated with acombined therapy,i.e.,preoperative intra-arterial infusion chemo-embolization,surgical therapy and postoperative radiotherapy,and those in the control group (n=57) were given surgical therapyand post-operative radiotherapy.The adverse effects,changes inlocal lesion and pathological examinations of the cancer,and thestate during the surgery were observed after the intra-arterialinfusion chemo-embolization.The survival rate and recurrencerate between the two groups were compared.RESULTS The total effective rate of the intra-arterial infusionchemo-embolization on Stage IB_2-IIB UCC was 93.02%.Thetreatment could reduce tumor size,bring about retro-conversionsof the clinical stage of the tumors and pathological grade of thecancer cells,and decrease the quantity of intra-operative bloodloss as well as the operating time.It could significantly improvethe 5-year survival rate (P<0.05),and reduce the 2 and 5-yeartumor recurrence rates (P<0.05).Moreover,its side effects werelittle.CONCLUSION Preoperative intra-arterial infusion chemo-embolization can create conditions for radical operation,lower thepostoperative recurrence rate,and improve the prognosis in thepatients with UCC.It is an effective therapy in treating UCC.

治疗135例脑恶性星形细胞瘤的探讨

目的 :分析脑恶性星形细胞瘤手术后采用单纯放射治疗及放疗加颈动脉化疗的疗效。材料与方法 :1987年 8月～ 1992年 11月收治 135例脑恶性星形细胞瘤。分两组治疗 ,单放组 71例 ,综合组 6 4例。两组放疗剂量 DT5 5～ 70 Gy。综合组术后 4～ 15天行颈动脉化疗 ,10～ 15天后行放疗 ,放疗结束再化疗 1～ 3次。结果 :单放组中位生存期 17.5个月 ,综合组为 31.9个月。其中效果最好的是多形性胶质母细胞瘤。33例中 2 ,3,5年生存率分别 70 %、36 %、15 %。结论