个体化综合治疗人脑恶性胶质瘤的临床研究

目的 :探讨人脑恶性胶质瘤个体化综合治疗的临床疗效。方法 :3 1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个月同步分别行经皮穿刺注入敏感化疗药物及全脑增敏放疗 ,2Gy/次 ,5次 /疗程 ,总量 5 0Gy。手术后及化放疗间歇期内输注自体细胞因子诱导的杀伤细胞 ,2× 10 9,进行免疫治疗。结果 :3 1例恶性脑胶质瘤患者生存期明显延长 ,1年生存 2 6例 (86% )、2年生存 2 1例 (67% )、3年生存 19例 (61% ) :全部患者均无明显的不良反应 ,生存质量得到明显改善。结论 :显微手术力争全切除 ,术后敏感药物间质化疗联合增敏放疗 ,序贯自体免疫治疗 ,是一种个体化综合治疗人脑恶性胶质瘤的安全有效手段。

Clinical investigation of individual comprehensive therapy on malignant human brain gliomas

Objective: To investigate the effectiveness of individual comprehensive therapy for malignant human brain gliomas.Methods: In 31 patients with malignant brain gliomas,the tumor was microsurgically removed and initial chemotherapy bursa were embeded in the tumor bed during operation.The drug of chemotherapy was selected by drug sensitive test in vitro.The sensitive drug was injected into chemotherapy bursa in the 2th、4th、8th、twelfth week 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.Postoperation and the intervals of interstitial chemotherapy and sensitive radiotherapy,patients were received immunotherapy of autologus dendritic cell vaccination.Results: After a follow_up of 3 years,life time extended,survival is 26 of 31 after one year,21 of 31 after two years,and 19 of 31 after 3 years.All the patients had no apparent side_effects and life quality were improved.Conclusion: Microsugical resection combined with interstitial chemotherapy and sensitive radiotherapy plus autologus immunotherapy is the safe and effective method of individual comprehensive therapy in malignant human brain gliomas.