医学影像引导下注射乙醇联合微波消融术治疗复发性恶性神经鞘瘤的疗效分析  

Efficacy analysis on medical imaging-guided ethanol injection combined with microwave ablation in patients with recurrent malignant schwannoma

作　　者：吕然 冯庆亮 李永杰 徐艳军 贾秀青 

机构地区：[1]聊城市肿瘤防治院肿瘤内科,山东聊城252000

出　　处：《实用肿瘤杂志》2013年第3期277-280,共4页Journal of Practical Oncology

摘　　要：目的采用医学影像引导下瘤体内注射无水乙醇联合微波消融术治疗恶性神经鞘瘤,分析其治疗效果。方法对8例术后复发无法再次手术切除的恶性神经鞘瘤患者,采用CT或超声引导下先向瘤体内注射乙醇再联合微波消融治疗,观察治疗前后患者临床症状改善情况、肿瘤局部治疗效果及远期疗效。结果治疗后8例患者临床症状均得到不同程度改善,Karnofsky评分由治疗前的67.52±10.50提高到85.33±14.32(P=0.013)。治疗后增强CT扫描显示肿瘤无强化并且体积逐渐缩小,随访至6月,体积由治疗前的(34.65±9.27)cm3减小到(24.51±6.32)cm3(P=0.011);随访期24-62月,生存6例,死亡2例;未出现与治疗相关的并发症。结论注射乙醇联合微波消融治疗恶性神经鞘瘤具有微创、无明显并发症、局部疗效明显等优点,可作为术后复发患者的补充治疗方法。Objective To analyze the therapeutic effect of medical imaging-guided intratumoral injection of ethanol combined with microwave for the treatment of recurrent malignant schwannoma. Methods Eight patients with recurrent malignant schwannoma who could not be re-resected were injected with ethanol intratumorally under CT or ultrasound and then combined with microwave ablation. The improved clinical symptoms after treatment, the local tumor control effect and the long-term efficacy were observed. Results After treatment, the clinical symptoms in 8 patients were improved by varying degrees. The Kamofsky score was raised from 67.52 ± 10.50 before treatment to 85.33 ± 14.32 （P = 0. 013）. Enhanced CT scan showed no tumor enhancement and the volume was gradually reduced from （34.65 ± 9.27 ） cm3 before treatment to （ 24.51 ± 6.32 ） cm3 （ P = 0. O11 ） ai^er six-month follow-up. The overall follow-up was 24 to 62 months. Six eases were surviving and 2 died and no obvious treatment-related complications were discovered. Conclusion Ethanol injection combined with microwave ablation for the treatment of malignant sehwannoma shows minimal invasion, slight eomplieations and signifieant local efficacy and can be used as a supplementary treatment for patients with recurrent malignant schwannoma.

关 键 词：神经鞘瘤 微波消融术 经皮无水酒精注射术 复发 

分 类 号：R730.5[医药卫生—肿瘤]