卡莫司汀瘤腔内灌注化疗治疗初发高级别胶质瘤  

Carmustine intratumoral infusion chemotherapy for treating initial high-grade gliomas

作　　者：钱海鹏[1] 万经海[1] 李学记[1] 孟肖利[1] 左赋兴[1] 杨逸坤[1] 刘昂斯[1] 

机构地区：[1]中国医学科学院肿瘤医院,北京100021

出　　处：《中国医刊》2012年第7期36-38,共3页Chinese Journal of Medicine

基　　金：北京希望马拉松专项基金资助(基金编号LC2009B36)

摘　　要：目的探讨卡莫司汀瘤腔内灌注化疗治疗初发高级别胶质瘤的效果。方法经手术病理证实为高级别胶质瘤的初治患者11例,2例肿瘤位于小脑半球,9例位于大脑半球。肿瘤最大径2.5～6cm,平均4.1cm。开颅手术,冰冻病理证实为分化较差的胶质细胞肿瘤,全切除或次全切除后,将卡莫司汀注射液62.5mg溶于10ml生理盐水中,均匀喷洒灌注于术腔,留院观察10～22天。结果住院期间并发症包括:癫痫1例,感染1例,失语1例,发热2例,皮下积液2例。间变星形胶质细胞瘤2例,胶质母细胞瘤9例。随访6～25个月,2例死亡,2例复发,1例影像进展。生存患者karnofsky评分60～80分,平均66分。结论卡莫司汀瘤腔内灌注化疗安全有效,可用于初发高级别胶质瘤术中治疗,不影响术后放疗,结合辅助放疗后疗效更佳。Objective To investigate the effect of carmustine intratumoral infusion chemotherapy on the initial high- grade gliomas. Methods 11 patients with pathologically confirmed with previously untreated high-grade gliomas, 4 males and 7 females, age between 33 to 62 years, with an average 52.3 years. Two cases of tumors located in the cerebellar hemispheres, nine cases in the cerebral hemispheres. The maximum tumor diameter was range from 2.5 to 6cm, with an average of 4. l cm. Craniotomy performed, frozen pathologically confirmed as poorly differentiated glial cell tumors, after total resection or subtotal resection, carmustine injection 62.5mg dissolved in 10ml saline was sprayed evenly in the operative cavity. Stay in hospital, observed 10 to 22 days. Results During hospitalization complications include ： one case of epilepsy, one of infection, one of aphasia, two of fever, two of subcutaneous flu- id. Two cases were anaplastic astrot^ytomas, nine cases were gliohlastomas. All were followed up for 6 to 25 months, 2 deaths, 2 cases of recurrence, 1 case of image progress. The survival patients karnofsky scores were 60 to 80 points, with an average of 66 points. Conclusion The carmustine tumor cavity infusion chemotherapy is safe and effective, can be used for the onset of high grade glioma patients, treatment does not affect postoperative radio- therapy, combined with adjuvant radiotherapy brings better efficacy.

关 键 词：胶质瘤 瘤腔内灌注 化疗 卡莫司汀 

分 类 号：R734[医药卫生—肿瘤]