手术联合125I粒子植入治疗复发性脑胶质瘤

目的探讨手术联合125I粒子植入治疗复发性脑胶质瘤的临床效果。方法2007年2月至2009年12月收治49例复发脑胶质瘤患者，采用显微手术联合125I粒子植入治疗26例（观察组），显微手术切除联合常规外放射治疗23例（对照组），术后长期随访直至死亡，记录和分析两组患者的生存时间和并发症。结果全部病例随访22～158周，平均55．8周。观察组术后平均生存时间为（62．8±5．6）周，中位生存时间为55周；对照组平均生存时间为（46．9±4．8）周，中位生存时间为39周；两组生存期差异有统计学意义（P〈0．05）。观察组术后出现放射性脑病5例，癫痫7例；对照组术后出现放射性脑病6例，癫痫5例；两组并发症发生率分别为46．2％和47．8％，差异没有统计学意义（P〉0．05）。结论手术联合125I粒子植入治疗复发性脑胶质瘤疗效优于手术后补充外放射治疗，能安全有效地延长患者的生存时间。

Microsurgery and 125I seeds implantation for recurrent malignant glioma

Objective To explore the clinical effect of microsurgery combined with 125I seeds implantation on recurrent malignant gliomas. Methods Forty-nine patients with recurrent malignant gliomas were randomly divided into observed group （n=26）, where 125I seeds implantation was performed immediately after the excision of the tumors via the microsurgery and control group （n=23）, where routine radiotherapy was performed 2-4 weeks after the microsurgery. All the patients were followed up after the operation up to death. Results The survival time （62.8±5.6） weeks]was significantly longer in the observed group than that in the control group （46.9±4.8） weeks] （P〈0.05）. The complications included radiation encephalopathy in 5 patients and epileptic seizure in 7 patients of the observed group, and radiation encephalopathy in 6 patients and epileptic seizure in 5 patients of the control group. There was insignificant difference in the rate of the complication occurrence between both the groups （P〉0.05）. Conclusion The clinical effect of microsurgical excision combined with 125I seeds implantation on recurrent malignant gliomas is significantly better than that of microsurgery combined with routine radiotherapy.