手术切除联合间质内缓释化疗治疗复发性脑胶质瘤

目的 探讨外科手术切除与瘤床问质内缓释化疗治疗复发性脑胶质瘤的疗效。方法 对30例复发性恶性脑胶质瘤患者行开颅手术全切除,术中在瘤床植入Vp-16多聚缓释体,用量为100～150mg。随访3～24个月,观察肿瘤再次复发率和患者死亡率,并与以前随访的46例再次手术的恶性脑胶质瘤结果相对比。结果 30例患者均获随访,3个月复发5例(16．7％),死亡2例(6．7％);6个月复发9例(30．0％),死亡6例(20．0％);12个月复发15例(50．0％),死亡12例(40．0％);24个月复发25例(83．3％),死亡21例(70．0％);全部患者均无化疗不良反应。结论 力争手术全切除联合瘤床间质内缓释化疗,可提高药物在瘤灶处的浓度和作用时间,从而提高复发性脑胶质瘤的疗效。

Treatment of recurrent malignant brain gliomas by surgical excision combined with biodegradable polymers of interstitial chemotherapy

OBJECTIVE: To investigate the effectiveness of treatment of recurrent malignant brain gliomas by surgical excision combined with biodegradable polymers of interstitial chemotherapy. METHODS: In 30 patients with recurrent malignant brain gliomas, the tumor was surgically removed and Vp-16 biodegradable polymers were implanted during operation in the tumor bed at a dose of 100 - 150 mg. The patients were followed up for 3 - 24 months, and the results were compared with 46 cases with the recurrent malignant brain gliomas who received operation only. RESULTS: At 3, 6, 12, 24 months after treatment, the recurrent rate was 16.7%, 30%, 50% and 83.3%, respectively; the mortality rate was 6.67%, 20%, 40% and 70%, respectively. All the patients had no apparent side-effects of chemotherapy. CONCLUSION: Surgical treatment combined with interstitial chemotherapy with biodegradable Vp-16 polymers improves the treatment result of recurrent malignant brain gliomas compared to surgery alone.