脑肿瘤化疗疗效与MRI强化效应的关系研究  

A Relationship Analysis between the Chemotherapeutic Effect on Brain Tumor and Their Enhancement MRI

作　　者：宋文广[1] 王毅峰[1] 刘睿[1] 杨照环[1] 房芳[1] 王瑞林[1] 李国忠[1] 张志[1] 

机构地区：[1]河北医科大学唐山工人医院放化疗科,河北省唐山市063000

出　　处：《中国全科医学》2010年第30期3373-3375,共3页Chinese General Practice

摘　　要：目的探讨脑肿瘤化疗疗效与脑MRI强化效应的关系。方法回顾性分析131例脑肿瘤患者的病历资料,按诊断分为原发性脑肿瘤和脑转移癌,按脑MRI强化效应分为无明显强化和有明显强化,按治疗方案分为亲脂方案和非亲脂方案,按疗效分为完全缓解(CR)、部分缓解(PR)、稳定(SD)和进展(PD),统计分析各类脑肿瘤应用不同的治疗方案化疗的疗效与MRI强化效应的关系。结果 39例原发性脑肿瘤患者中MRI无明显强化者23例,其中2例(8.7%)有效(PR),均为采用亲脂方案治疗者;MRI有明显强化16例,其中7例(43.8%)有效(CR+PR),二者疗效比较差异有统计学意义(χ2=6.532,P=0.011)。MRI有明显强化的患者应用亲脂方案与非亲脂方案的疗效分别为4/9和3/7,差异无统计学意义(χ2=0.004,P=0.949)。脑转移癌患者92例,9例MRI无明显强化的患者中仅1例(1/9)有效,且为采用亲脂方案治疗者;83例MRI有明显强化的患者中49例(59.0%)有效,二者疗效比较差异有统计学意义(χ2=7.516,P=0.006)。在MRI有明显强化的患者中应用亲脂方案和非亲脂方案的疗效分别为2/6和61.0%,二者疗效比较差异无统计学意义(χ2=1.767,P=0.184)。结论脑肿瘤化疗疗效的高低与MRI强化效应的强弱高度吻合,MRI有明显强化者血-脑脊液屏障功能丧失,不论是原发性脑肿瘤还是脑转移癌均可应用非亲脂性药物治疗。Objective To investigate the relationship between the chemotherapeutic effect on brain tumors and the enhancement effect of its MRI.Methods Retrospectively analyze 131 patients with brain tumors,which were divided into two groups as primary and metastatic tumors by the diagnosis,non-enhancement and enhancement effect by the brain MRI,lipophil and hydrophil by the treatment regimen.The therapeutic effect was classified as CR,PR,SD and PD conventionally.The relationship between the chemotherapeutic effect on brain tumors and the enhancement of their MRI was analyzed with statistical software SPSS 17.0.Results In 39 patients with primary brain tumors,there were 23 patients with non-enhancement MRI,and 2 of them achieved PR,both of whom came from lipophilic regimen;there were 16 patients with enhancement MRI with 7 effective （CR＋PR）.There were significant difference between the two groups（χ2=6.532,P=0.011）.In the patients with enhancement MRI,the effective rate of lipophilic regimen and hydrophilic regimen was 44.4%（4/9） and 42.9%（3/7） respectively,the difference was not significant（χ2=0.004,P=0.949）.In 92 patients with metastatic tumors,there were 9 patients with non-enhancement MRI,and only 1（11.1%） achieved PR;on the other hand,49 of 83（59.0%） patients with enhancement MRI achieved CR or PR.In those patients with enhancement MRI,the effective rate of lipophilic regimen and hydrophilic regimen was 33.3%（2/6）and 61.0%（47/77） respectively,and the difference was not significant（χ2=1.767,P=0.184）.In aggregate analysis,the effective rate in patients with non-enhancement MRI was 9.4%（3/32）,while 56.6% in enhancement patients;the overall efficiency of lipophilic regimen and hydrophilic regimen were 0 and 59.5% respectively.Conclusion The effects of chemotherapy in patients with brain tumors are highly concordant with the enhancement effect of their MRI.The enhancement effect of MRI indicates a deprivation of blood-brain barrier （BBB）,thus the hydrophilic agents can be a

关 键 词：脑肿瘤 抗肿瘤联合化疗方案 磁共振成像 血脑屏障 

分 类 号：R739.41[医药卫生—肿瘤]