人脑恶性胶质瘤个体化综合治疗临床观察.docVIP

人脑恶性胶质瘤个体化综合治疗临床观察步星耀 赵跃武 韩倩 赵红卫 张永福 【摘要】 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 对31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50Gy。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,2×109，进行免疫治疗。结果 31例恶性脑胶质瘤患者生存期明显延长,1年生存26例（86%）、2年生存21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。 关键词：胶质瘤 间质化疗 放疗 细胞因子诱导的杀伤细胞 过继免疫治疗 文章编号：1008-6919（2006）07-0046-03 中图分类号:R739.4 文献标识码：A Clinical investigation of individual comprehensive therapy on m alignant human brain gliomas [ Abstract ] ObjectiveTo investigate the effectiveness of individual comprehensive therapy for m alignant human brain gliomas. Methods In 31 patients with m alignant 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、welfth week after operation respectively. Concurrently, volume dose of 50Gy 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 m alignant human brain gliomas. Keywords: GliomaInterstitialchemotherapyRadiotherapyCIKImmunotherapy 脑胶质瘤通常呈浸润性生长,在肿瘤周围2cm以内的正常脑组织中均可能有肿瘤细胞生长。因此,手术难以全切,术后易复发,术后采用传统的放疗、化疗等治疗效果亦不理想，患者生存期仅为数月，且毒副反应大，生存质