手术联合125I粒子植入治疗脑复发恶性胶质瘤的临床应用分析

目的探讨手术联合125I粒子植入治疗脑复发恶性胶质瘤的临床疗效。方法回顾性分析手术联合125I粒子植入治疗17例复发的脑胶质瘤患者的临床资料，观察患者术后情况、生存时间等指，并采用Kaplan-Meier法对全组累积生存率进行分析。结果17例患者均获得随访，其中14例（82．4％）患者死亡，3例（17．6％）患者仍然存活，随访时间32～168w，总体中位生存时间72w，间质内放疗后中位生存时间45w，6个月无进展生存率为42％，行间质内放疗后，生存质量评分（karnofsky performance scale，KPS）评分≥70分患者中位生存时间为55w，KPS评分〈70分患者中位生存时间为43w，其生存时间差异无统计学意义（P〉0．05），术后及随访过程中未出现严重并发症。结论手术联合125I粒子永久性植入治疗脑复发恶性胶质瘤具有可操作性强、安全性高等特点，可显著延长患者的整体生存时间，提高患者的整体生存质量，对于脑复发恶性胶质瘤是一项有效的治疗手段。

Clinical analysis of operation combined with 125I seeds implantation in the treatment of recurrent malignant glioma

Objective To evaluate the clinical efficacy of operation combined with 125i seeds brachytherapy for recurrent malignant glioma. Methods Retrospectively studied the perioperative 12s I seeds brachytherapy in the treatment of 17 cases of recurrence of malignant glioma with clinical data; analyzed postoperative situation and survival time; used the Kaplan-Meier method to calculate the whole group of cumulative survival rate. Results During follow-up study, 14 patients （82.4%） died and 3 patients （17.6%） were alive. The follow-up time was 32--168 weeks. Median overall survival from diagnosis amounted to 72 weeks. Median survival after recurrence was 45 weeks, and 6-month progression-free survival was 42%. The survival time of patients between KPS ≥70 and KPS 〈70 were no statistical difference （P 〉0.05）. No severe complications in postoperative and follow-up process had been observed. Conclusion The method of perioperative 125I seeds brachytherapy in the treatment of recurrent malignant glioma has well operability, high security features, and it can significantly prolong overall survival time of patients and improve the overall quality of life, this method for recurrent malignant glioma is an effective treatment method.