显微手术联合5-FU及放射性(125)~I粒子永久植入治疗复发性脑胶质瘤  

Treatment of recurrent malignant brain gliomas by microsurgical excision combined with (125)~I and 5-FU embedded

作　　者：张广健[1] 郝彩江[2] 葛明芹 杨卫东[1] 刘阳[1] 郝志东[1] 

机构地区：[1]天津医科大学总医院神经外科,300052 [2]天津市海河医院神经外科 [3]临沂市第二人民医院内分泌科

出　　处：《中华临床医师杂志（电子版）》2011年第9期2543-2548,共6页Chinese Journal of Clinicians(Electronic Edition)

基　　金：天津市科技计划项目(06YFJMJC07900)

摘　　要：目的探讨显微外科手术切除与瘤床间质内放化疗治疗复发性脑胶质瘤的临床疗效。方法对21例恶性脑胶质瘤患者行开颅显微手术切除,术中于瘤床表面植入125I和5-氟尿嘧啶(5-FU),每颗粒子活度0.7～0.8mCi,125I粒子间距<10mm,非功能区设定为80Gy,功能区为50Gy,5-FU总量约为100～150mg,植入范围达影像学边界2cm,随访6～25个月,并与以前随访的32例接受肉眼下全切后常规放化疗的脑胶质瘤结果相比较。结果间质放化疗组1例于术后4周死亡,余20例患者均获随访,6个月内有效18例(85.7%),死亡3例(14.3%);12个月内有效14例(66.7%),死亡7例(33.3%);18个月内有效10例(47.6%),死亡11例(52.4%),生存期较对照组明显延长(P<0.05),无明显不良反应。结论手术全切除联合瘤床间质内放化疗可提高复发性脑胶质瘤的疗效,值得临床推广。Objective To investigate the clinical curative effect of recurrent malignant brain gliomas by microsurgical excision combined with interstitial chemotherapy and sensitive radiotherapy.Methods In 21 patients with recurrent malignant brain gliomas,the tumor was microsurgically removed and 125I and 5-FU were embeded in the tumor bed during operation.The patients were followed up for 6-25 months,and the results were compared with 32 cases with the recurrent malignant brain gliomas who received operation,chemotherapy and radiotherapy.Results A patient died in 4 weeks.In 6 months,12 months,18 months,the effective rate was 85.7%,66.7% and 47.6%;the mortality rate was 14.3%,33.3% and 52.4%.All patients had no apparent side-effects.Conclusions Microsurgical resection combined with interstitial chemotherapy and sensitive radiotherapy is an effective method for the treatment of recurrent malignant brain gliomas.

关 键 词：神经胶质瘤 外科手术 计算机辅助 碘放射性同位素 氟尿嘧啶 

分 类 号：R739.4[医药卫生—肿瘤]