显微手术后间质化疗联合增敏放疗治疗恶性脑胶质瘤

目的：探讨显微外科手术后间质化疗联合增敏放疗治疗脑胶质瘤的临床疗效。方法：对45例恶性脑胶质瘤患者行开颅显微手术全切除，术中于瘤腔内安置化疗囊，并行化疗药物体外敏感性及放疗增敏作用检测，术后第2，4，8，12周和6个月分别行经皮穿刺注入敏感化疗药物联合增敏放疗。随访6～36个月，并与以前随访的40例接受肉眼下全切后常规放化疗的脑胶质瘤结果相比较。结果：45例患者均获随访，生存期明显延长，6个月内复发4例(8．8％)，死亡3例(6．6％)；1年内复发9例(20．0％)，死亡7例(15．6％)；2年内复发19例(42．2％)，死亡15例(33．3％)；3年内复发25例(55．6％)，死亡22例(48．9％)。未发现明显的不良反应，生存质量得到明显改善。结论：显微外科手术力争全切除，术后敏感药物间质化疗联合增敏放疗，是一种可供选择的治疗人脑恶性胶质瘤安全有效的方法。

Treatment of malignant brain gliomas using interstitial chemotherapy combined with sensitive radiotherapy after microsurgical excision

Objective To investigate the effect of interstitial chemotherapy combined with sensitive radiotherapy on malignant brain gliomas after microsurgical excision. Methods In 45 patients with malignant brain gliomas,the tumor was microsurgically removed and interstitial chemotherapy bursa were embeded in the tumor bed during operation. The drug of chemotherapy and sensitive radiotherapy was selected by drug sensitive test in vitro. The sensitive drug was injected into chemotherapy bursa in the 2nd, 4th, 8th, 12th week and 6th month after operation respectively. Concurrently, volume dose of 50 Gy sensitive radiotherapy to whole brain was performed 5 times a week with 2 Gy each time for a period. The patients were followed up for 6-36 month, and the results were compared with 40 cases of malignant brain gliomas who received traditional operation and normal radiotherapy and chemotherapy. Results In 6 months, 1 year, 2 years, 3 years after treatment, the recurrent rate was 8. 8%,20. 0%,42. 2% and 55. 6% respectively; the mortality rate was 6. 6%, 15. 6%, 33. 3% and 48. 9% respectively. All the patients had no apparent side effect and life quality was improved. Conclusion Microsurgical resection combined with interstitial chemotherapy and sensitive radiotherapy is a safe and effective method for the treatment of malignant human brain gliomas.