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目的观察再次手术切除结合放射性同位素125I粒子植入治疗复发脑胶质瘤的近期疗效。方法2002年6月~2004年12月在我院住院治疗的23例复发脑胶质瘤病人为治疗组,采用手术切除肿瘤后,在瘤床或残余肿瘤内植入125I粒子作内放射治疗,观察病人术后1个月时功能改善情况及术后生存期情况。同期再手术切除加普通放射治疗的28例病人为对照组,和治疗组进行比较。结果治疗组:23例肿瘤全切除17例,次全切除6例;全部病例均植入125I粒子;术后1个月时19例患者的功能情况改善,KPS分值提高;再手术后生存期为25~216周,平均65.7周。对照组中全切除19例,次全切除9例;术后1个月时20例患者的功能情况改善,再手术后平均生存期60.5周。两组比较有统计学意义。结论再手术切除结合125I粒子植入治疗复发脑胶质瘤,可扩大局部控制范围,能有效地缓解病情,提高患者的生存质量,延长患者的生命,是一种有效的治疗方法。
Objective To observe the short-term curative effect of reoperation combined with radioactive isotope 125I implantation on recurrent glioma. Methods Twenty-three patients with recurrent glioma hospitalized in our hospital from June 2002 to December 2004 were treated with radioactive 125I seeds implanted in the tumor bed or residual tumor after surgical removal of the tumor. Observe the patients after 1 month of functional improvement and postoperative survival. During the same period, 28 patients underwent resection and general radiotherapy were compared with the control group. Results In the treatment group, 17 cases were resected in 23 cases and 6 cases were subtotally resected. In all cases, 125I particles were implanted. At 1 month after operation, the functional status of 19 patients improved and the KPS score increased. Survival time For 25 to 216 weeks, an average of 65.7 weeks. In the control group, 19 cases were completely resected and 9 cases were subtotally resected. At 1 month after operation, the functional status of 20 patients improved and the average survival time after reoperation was 60.5 weeks. The two groups were statistically significant. Conclusion Reoperation combined with 125I seed implantation in the treatment of recurrent glioma can expand the scope of local control, which can effectively relieve the disease, improve the quality of life of patients and prolong the life of patients. It is an effective treatment.