[1]杨辉,张富强,李文亮,等.术中125Ⅰ粒子植入治疗复发性脑胶质瘤的临床研究[J].国际放射医学核医学杂志,2013,37(6):345-348.[doi:10.3760/cma.j.issn.1673-4114.2013.06.005]
　YANG Hui,ZHANG Fu-qiang,LI Wen-liang,et al.Clinical study of operation combined with 125Ⅰ seeds implantation in the treatment of recurrent cerebral glioma[J].International Journal of Radiation Medicine and Nuclear Medicine,2013,37(6):345-348.[doi:10.3760/cma.j.issn.1673-4114.2013.06.005]
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术中125Ⅰ粒子植入治疗复发性脑胶质瘤的临床研究(/HTML)
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《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
37
期数:
2013年第6期
页码:
345-348
栏目:
论著
出版日期:
2013-11-25

文章信息/Info

Title:
Clinical study of operation combined with 125Ⅰ seeds implantation in the treatment of recurrent cerebral glioma
作者:
杨辉1;  张富强1;  李文亮1;  徐欣2;  李德宇1;  王重韧2;  赵明2
1. 郑州大学附属肿瘤医院(河南省肿瘤医院)核医学科, 郑州 450008;
2. 郑州大学附属肿瘤医院(河南省肿瘤医院)神经外科, 郑州 450008
Author(s):
YANG Hui1;  ZHANG Fu-qiang1;  LI Wen-liang1;  XU Xin2;  LI De-yu1;  WANG Zhong-ren2;  ZHAO Ming2
Department of Nuclear Medicine, Affiliated Tumor Hospital of Zhengzhou University Henan Provincial Tumor Hospital, Zhengzhou 450008, China
关键词:
神经胶质瘤; 碘放射性同位素; 近距离放射疗法
Keywords:
Glioma; Iodine radioisotopes; Brachytherapy
DOI:
10.3760/cma.j.issn.1673-4114.2013.06.005
摘要:
目的 探讨复发性脑胶质瘤术中125Ⅰ粒子植入治疗的近期治疗效果及并发症.方法 回顾性分析58例复发性脑胶质瘤患者资料,其中,23例患者行单纯手术,另外35例利用计算机三维治疗计划系统于术前或术中制定治疗计划,术中依据所制定的剂量,在肿瘤切除后的瘤床上植入125Ⅰ粒子,处方剂量为140~188 Gy.术后每2个月复查CT或MRI进行验证和质量评估,随访8~32个月,比较分析两组患者的肿瘤复发率、生存期及放射性并发症.结果 单纯手术组中有20例复发,复发率为87.0%;有3例死于术后并发症.术中125Ⅰ粒子植入治疗组中有23例复发,复发率为65.7%;有5例死于术后并发症,4例发生顽固性脑水肿,3例发生放射性脑坏死.术中125Ⅰ粒子植入治疗组肿瘤复发时间[(97.5±15.3)周]明显长于单纯手术组[(62.5±13.6)周](t=9.21,P<0.05),生存期[(60.3±7.1)周]亦明显长于单纯手术组[(43.1±5.5)周(t=13.03,P<0.05).单因素变量分析结果显示,世界卫生组织肿瘤病理分级与肿瘤切除程度是影响患者生存率的独立因素.结论 术中125Ⅰ粒子植入治疗可降低脑胶质瘤的复发率,有效增加复发性脑胶质瘤患者的生存时间.
Abstract:
Objective To explore the therapeutic effect and complications of operation combined with 125Ⅰ seeds implantation in the treatment of brain glioma.Methods A retrospective analysis was underwent in 58 cases of recurrent cerebral glioma patients,among them,23 patients were treated with simple operation,35 cases were given treatment plans by three-dimensional treatment planning system in preoperation or intraoperation,and according to the does set in intraoperation,125Ⅰ seeds were implanted in the tumor bed after tumor resection with the prescription dose was 140-188 Gy.Verification and quality evaluation was performed every 2 months by CT or MRI.After 8-32 months follow-up,tumor recurrence rate,survival time and complications were compared between the two groups.Results There were 20 cases of recurrence in the simple operation group and the recurrence rate was 87%,3 patients died of postoperative complications.There were 23 cases of recurrence in the intraoperative 125Ⅰ seeds implantation group and the recurrence rate was 65.7%; 5 patients died of postoperative complications,4 cases of refractory cerebral edema,3 cases of radiation necrosis of the brain.The recurrence time in intraoperative 125Ⅰ implantation group [(97.5±15.3) weeks] was significantly greater than that in simple operation group [(62.5±13.6) weeks] (t=9.21,P<0.05),the survival time [(60.3±7.1) weeks] was significantly longer than that in simple operation group [(43.1±5.5) weeks] (t=13.03,P<0.05).Conclusion 125Ⅰ seeds implantation treatment intraoperative could reduce glioma recurrence rate,effectively improve the survival time in recurrent glioma patients.

参考文献/References:

[1] Larson DA, Suplica JM, Chang SM, et al. Permanent iodine 125 brachytherapy in patients with progressive or recurrent glioblastoma multiforme. Neuro Oncol, 2004, 6(2):119-126.
[2] Patel S, Breneman JC, Warnick RE, et al. Permanent iodine-125 interstitial implants for the treatment of recurrent glioblastoma multiforme. Neurosurgery, 2000,46(5):1123-1128.
[3] Hu X, Qiu H, Zhang L, et al. Recurrent gliomas:comparison of computed tomography (CT)-guided 125I seed implantation therapy and traditional radiochemotherapy. Cancer Biol Ther, 2012, 13(10):840-847.
[4] 王继跃,张士刚,孙学礼,等.脑胶质瘤的综合治疗一附72例临床分析.肿瘤防治杂志,2001,8(5):520-521.
[5] Darakchiev BJ, Albright RE, Breneman JC, et al. Safety and efficacy of permanent iodine-125 seed implants and carmustine wafers in patients with recurrent glioblastoma multiforme. J Neurosurg, 2008, 108(2):236-242.
[6] 程敬民,顾建文,屈延,等.手术切除联合放射性粒子永久性植人治疗复发性胶质瘤.临床神经外科杂志,2008, 5(4):179181.
[7] 肖勇,刘健,李玉明,等.叫放射性粒子永久植人治疗脑胶质瘤的临床探讨.中国临床神经外科杂志,2010, 15(11):676-678.

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备注/Memo

备注/Memo:
收稿日期:2013-07-15。
通讯作者:杨辉,Email:13938276142@163.com
更新日期/Last Update: 1900-01-01