手术切除结合术后间质内放化疗治疗脑恶性胶质瘤  

Interstitial radiotherapy combined with chemotherapy for postoperative malignant gliomas

作　　者：杨小放 王世波[2] 李敬伟[3] 张旭海[1] 王亚林[1] 杨哲[1] 董景珍 

机构地区：[1]唐山市丰南区人民医院神经外科,63300 [2]天津环湖医院神经外科 [3]天津环湖医院眼科

出　　处：《临床神经外科杂志》2010年第2期98-99,共2页Journal of Clinical Neurosurgery

摘　　要：目的探讨脑恶性胶质瘤切除术后结合间质内放疗并问质内化疗的临床疗效。方法 32例脑恶性胶质瘤均行显微神经外科手术全切除或次全切除,术中根据术前计算机三维治疗计划系统(TPS)在瘤床上植入^(125)I放射性粒子行组织问持续内照射,总量为50～60 Gy,同时于瘤腔内放置Ommagy化疗囊,术后1周开始应用盐酸尼莫司汀(ACNU)行间质化疗,每周1次,连续6周。随访观察肿瘤复发率、患者生存率、中位生存期。结果 32例患者1、2年复发率分别为31.2%、68.8%,1、2、5年生存率分别为94.3%、80.6%、29.1%,中位生存期为92.3周;无明显放疗、化疗并发症。结论在手术力争全切除肿瘤基础上结合术后间质内放疗、化疗治疗脑恶性胶质瘤,疗效较好,安全而且并发症少。Objective To investigate curative effects of interstitial radiotherapy combined with of interstitial chemotherapy on the postoperative malignant gliomas. Methods 32 patients with malignant gliomas underwent total resection or subtotal resection. ^125 I radioactive particles were implanted in the tumor bed intraoperatively to give internal irradiation in accordance with preoperative three-dimensional computer treatment planning system （ TPS）, total amount of 50 60Gy. Meanwhile the Ommagy sac were placed, and Nimustine Hydrochloride （ACNU） were used in interstitial chemotherapy one week later,lasted for 6 weeks. Follow：up observation included the rate of tumor recurrence, patient survival and the median survival time. Results Recurrence rates of 1 and 2 years were 31.2% and 68.8% ,survival rates of 1,2 and 5 years were 94.3% ,80.6% and 29.1%, with a median survival time was 92. 3 weeks, without radiotherapy and chemotherapy complications. Conclusion The curative effect of interstitial radiotherapy combined with interstitial chemotherapy on the postoperative glioma is good with safe and fewer complications.

关 键 词：脑胶质瘤 ~125I放射性粒子 间质放疗 间质化疗 

分 类 号：R739.41[医药卫生—肿瘤]