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作 者:张铭 周波 杨士勇 刘万明 全中平 杨宜洲 钟宝 王少波
机构地区:[1]湖北荆门市第二人民医院神经外科,荆门448000
出 处:《中国实用神经疾病杂志》2007年第6期17-18,共2页Chinese Journal of Practical Nervous Diseases
摘 要:目的研究12例复发性脑胶质瘤显微手术切除加125I粒子置入治疗复发性脑胶质瘤的近期治疗效果。方法对12例复发性恶性脑胶质瘤患者行开颅显微手术全切除,术中在瘤床植入125I粒子,每颗粒子活度0.3~0.4mCi,病灶周边剂量50~80Gy。随访6~18个月,观察肿瘤再次复发率和患者病死率。结果全组12例获得6~18个月的随访。12例中有2例复发病例,复发的时间分别是在治疗后9个月和15个月。有2例死亡病例,1例在术后15月复发放弃治疗后死亡,另1例在术后4月死于并发症,其余9例粒子聚集病灶无扩大化表现,CT增强也未见肿瘤复发。无1例发生急性放射性反应。有2例出现粒子游走,但无功能损害的表现。有4例粒子周围出现的水肿持续达4~7月,给以脱水治疗后好转。有2例病人术后肿瘤残腔出血,保守治疗好转。全组病人抗癫治疗,无癫病例发生。结论显微手术切除加125I粒子置入,可提高复发性脑胶质瘤的疗效。Objective To investigate the effect of treatment of recurrent brain gliorvas by microsurgical excision combined with ^125I seeds. Methods In 12 patients with recurrent brain gliomas, the tumor was microsurgically removed and ^125I seeds implantation. Each particle activity 0.3-0.4mCi, peripheral lesions dose of 50-80Gy. The patients were followed up for 6-18 months , and the mortality and recurrence rate of patients with tumor relapse were observed. Results The whole team was 6-18 months of follow-up of 12 patients, There were two cases recurrence of 12 cases, the recurrence time was in 9 months and 15 months after treatment. Two patients died, one patient died after 15 months of tumor relapse, and one died from complications in 4 months . The remaining nine cases particles showed no war performance , CT showed no tumor recurrence . None of the patients had acute radiation reaction . There were two cases seed migration, but no damage performance. There were four cases of edema around the particles around 4-7 months ,and given better treatment of dehydration . Two patients were residual tumor after hemorrhage , and drug therapy improved. All patients had served antiepileptic treatment , no case of epilepsy occured. Conclusion Microsurgical excision combined with ^125I seeds is able to enhance the efficacy of recurrent glioma.
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