手术联合碘125粒子植入治疗脑胶质瘤对瘤周血管的影响  

Influence of Operation Combined with Iodine-125 Radioactive Seeds Implantation on Peritumoral Blood Vessels in the Treatment of Glioma

作　　者：俞方毅 戴学军 林瑞生[2] 叶劲超 方力 欧志强 YU Fangyi;DA I Xuejun;LIN Ruisheng;YE Jingchao;FANG Li;OU Zhiqiang(Department of Neurosurgery,Guangzhou Red Cross Hospital,Guangzhou 510220,China;Department of Neurosurgery,Zhangzhou Municipal Hospital of Fujian Province,Zhangzhou 363000,China;Department of Pathology,Guangzhou Red Cross Hospital,Guangzhou 510220,China;Department of Radiology,Guangzhou Red Cross Hospital,Guangzhou 510220,China)

机构地区：[1]广州市红十字会医院神经外科,广东广州510220 [2]福建省漳州市医院神经外科,福建漳州363000 [3]广州市红十字会医院病理科,广东广州510220 [4]广州市红十字会医院放射科,广东广州510220

出　　处：《临床医学工程》2018年第9期1161-1162,共2页Clinical Medicine & Engineering

基　　金：广东省自然科学基金项目(项目编号:10151022001000005);广州市医药卫生科技项目(项目编号:2015A01002)

摘　　要：目的研究手术联合碘125粒子植入治疗脑胶质瘤对瘤周血管的影响。方法选取2015年6月至2016年12月我院收治的60例恶性脑胶质瘤患者,随机分为两组各30例。对照组单纯行显微手术切除胶质瘤,观察组在此基础上给予碘125粒子植入。比较两组患者的临床疗效,并于术后运用延迟增强三维磁化准备快速梯度回放波(3D-MPRAGE)技术分析瘤周血管情况。结果治疗24周后,两组患者存在不同程度的复发及瘤周血管生成。观察组的Ⅰ型、Ⅱ型、Ⅲ型瘤周血管数目和瘤周血管总数明显少于对照组(P <0.05)。观察组治疗72周后的生存率为80.00%,明显高于对照组的53.33%(P <0.05)。结论碘125粒子植入治疗可抑制瘤周血管生成,放疗效果显著,提高脑胶质瘤患者的生存率,更好地预防复发,是较为有效且安全的治疗方法。Objective To study the influence of operation combined with iodine-125 radioactive seeds implantation on peritumoral blood vessels in the treatment of glioma. Methods 60 cases of patients with malignant glioma admitted to our hospital from June 2015 to December 2016 were selected and randomly divided into two groups, with 30 cases in each group. The control group only received microneurosurgical resection for glioma, while the observation group received iodine-125 radioactive seeds implantation on this basis. The clinical curative effect was compared between the two groups. The peritumoral blood vessels were analyzed by delayed enhancement three-dimensional magnetization prepared rapid acquisition gradient echo sequences（3 D-MPRAGE） after surgery. Results After 24 weeks of treatment, both groups showed different degree of recurrence and formation of peritumoral blood vessels. The numbers of type Ⅰ, Ⅱ andⅢ peritumoral blood vessels and the total number of the observation group were significantly fewer than those of the control group（P0.05）. After 72 weeks of treatment, the survival rate of the observation group was 80.00%, significantly higher than 53.33% of the control group（P 0.05）. Conclusions Iodine-125 radioactive seeds implantation can inhibit the formation of peritumoral blood vessels with significant effect of radiotherapy, improve the survival rate of patients with glioma and prevent recurrence better, which is a relatively effective and safe treatment method.

关 键 词：显微手术 碘125 脑胶质瘤 瘤周血管 

分 类 号：R739.41[医药卫生—肿瘤]