超选择性颅内动脉灌注ACNU、VM-26治疗丘脑、脑干胶质瘤的临床疗效观察

目的 研究丘脑及脑干等不适于手术切除治疗的脑胶质瘤超选择性颅内动脉灌注 ACNU、VM-26的治疗效果及相关问题.方法 治疗组选择位于丘脑及脑干的脑胶质瘤 50例,肿瘤同侧颈内动脉及椎动脉ACNU、VM-26联合灌注化疗.对照组选择丘脑及脑干脑胶质瘤 20例,应用传统经静脉注射卡莫司汀 （卡氮芥,carmustine,BCNU）及口服司莫司汀 （甲环亚硝脲,MeCCNU）治疗,并行疗效对比.结果 超选择性颅内动脉灌注治疗的完全缓解（CR）、部分缓解 （PR）高于对照组,无变化（NC）、恶化 （PD）低于对照组,生存率、生存期高于对照组,差异有统计学意义.结论 超选择性颅内动脉灌注 ACNU、VM-26治疗丘脑及脑干等不适于手术切除治疗的脑胶质瘤疗效高,副作用小,安全可靠,可作为常规化疗手段.

Observation on the clinical effect of super selective intracranial artery perfusion ACNU and VM-26 for the treatment of hypothalamus and brainstem glioma

Objective To investigate the therapeutic effects of super--selective intracmnial arterial of ACNU and VM-26 to the glioma in thalamus and brain stem, which is not suitable for the treatment of the surgical resection. Methods The treatment group selected 50 eases of glioma in tbelamus and brain stem, combining ACNU with VM-26 to go on the infusion chemotherapy in tumor ipsilateral carotid artery and vertebral artery. The control group selected 20 cases of glioma in thalamus and brain stem and used traditional intravenous injection of carmustine （ BCNU, carmustine, BCNU）, and oral semustine （ MeCCNU, MeCCNU） treatment, comparative efficacy in parallel. Results Complete remissions （CR）, partial remission （PR） of super-selective intracranial arterial therapy were higher than the control group. No changes （NC）, deterioration （PD） were lower than the control group. Survival rates and survival period were higher than the control group. The difference was significant statistically. Conclusion Super-selective intracranial arterial of ACNU and VM-26 can be used as means of conventional chemotherapy to treat the glioma in thalamus and brain stem, because of high eificacy, little side effects, safety and reliability.