摘要
目的探讨131I-肿瘤细胞核人鼠嵌合单抗(131I-chTNT)在脑胶质瘤瘤内放免治疗的疗效。方法选择56例经手术病理证实的脑胶质瘤病人作为治疗组,其中胶质母细胞瘤34例,星形细胞瘤22例。第1次手术20例,复发后再次手术36例。术中瘤腔内置入化疗囊,术后7 d囊内注131I-chTNT 1.48×109 Bq(40 mCi),15 d后重复注入1次。对照组24例,均经病理证实为复发性星形细胞瘤,采用卡莫司汀6.0 g静注1次/d,连用3 d;间隔45 d后,重复1个疗程。结果治疗组于末次注药后2个月复查MRI,随访期6～26个月,显效21例(37.5%),有效24例(42.8%),微效7例(12.5%),恶化4例(7.1%)。对照组末次用药后1个月复查MRI,随访期3～24个月,有效2例(8.3%),微效11例(45.8%),恶化11例(45.8%)。经2χ检验,治疗组与对照组间疗效差异有统计学意义(P<0.05)。结论131I-chTNT脑胶质瘤瘤内放免治疗临床疗效满意,优于其他类型的瘤内近距离放疗。
Objective To explore the therapeutic effect of intratumoral radioimmunotherapy for brain glioma by radioiodinated monoclonal antibody （^131I-chTNT）. Methods Fitly-six patients in the treatment group were confirmed having brain glioma by pathology after surgery, including 34 cases of glioblastomas and 22 cases of astrocytoma. Twenty patients underwent first surgery and the other 36 did the second operation. The chemotherapeutic reservoirs were placed into the tumor cavities during surgery. 1.48 × 10^9 Bq （40 mCi） ^131I-chTNT was injected into the reservoir 7 days postoperatively. The injection was repeated once after 15 days. Twenty-four cases of pathologically confirmed relapsed astrocytomas were enrolled into the control group. These patients were injected with carmustine 6.0 g intravenously, 1 time a day for 3 days sequentially. After 45 days＇ interval, the procedure was repeated once. Results Two months after the last injection, all of the patients were reexamined with MRI in management group and followed up for 6-26 months. The results of the follow-up showed that 21 patients （37.5%） achieved complete remission, 24 （42.8%） partial remission, 7 （12.5%） minimal remission and only 4 （7.1%） deteriorated in the management group. One month after the last injection, all of the patients were reexamined with MRI and followed-up for 3-24 months in control group. Two cases （8.3%） reached partial remission, 11 （45.8%） minimal remission, and 11 （45.8%） deteriorated in control group. The x^2 test showed statistically significant difference between the two groups （P〈0.05）. Conclusion lntratumoral radiotherapy with ^131I-chTNT could obtain satisfactory clinical effect, which demonstrates a significant virtue compared with other interstitial brachytherapies for brain gliomas.
出处
《中国微侵袭神经外科杂志》
CAS
2007年第4期156-158,共3页
Chinese Journal of Minimally Invasive Neurosurgery
