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目的:研究~(192)铱核素行脑胶质瘤间质内放疗的的临床应用。方法:(1)实验:60只小鼠用 G422胶质母细胞瘤株制成 G422皮下荷瘤小鼠模型,作肿瘤生长抑制实验,病理学研究证明:~(192)铱瘤内置入可达到理想的照射,即可抑制瘤细胞生长,又可杀死瘤细胞;(2)临床:56例脑深部胶质瘤,采用立体定向术,行脑瘤间质~(192)铱照射,剂量参考距离<2cm,剂量依病理部位性质而定。结果:55例近期疗效:多数患者自觉症状减轻,6个月CT 或 MRI 复查,1/3的肿瘤水肿区稍增大,但症状无加重;1/3症状有改善,但肿瘤缩小不显著,有6例明显缩小;1/3病情变化不大,但术前所用脱水剂、激素已可停用。结论:~(192)铱参考点剂量达到摧毁肿瘤的目的,对患者无任何不良影响,使正常脑得到有效保护,术后1年尚未发现复发或恶化病例,处于稳态,近期疗效良好。
Objective: To study the clinical application of ~ (192) iridium nuclide in glioma interstitial radiotherapy. Methods: (1) Experiment: 60 mice were made into G422 subcutaneous tumor-bearing mouse model by G422 glioblastoma tumor model, and used as tumor growth inhibition experiment. The pathological study proved that: (192) Ideal irradiation, can inhibit the growth of tumor cells, but also kill tumor cells; (2) Clinical: 56 cases of brain deep glioma stereotactic surgery, brain tumor mesenchymal ~ (192) iridium irradiation dose reference Distance <2cm, the dose according to the nature of the site may be. Results: 55 patients had short-term curative effect: the subjective symptom of most patients was relieved, 6 months CT or MRI review, 1/3 of tumor edema area slightly increased, but the symptoms did not aggravate; 1/3 symptoms improved, 6 cases significantly reduced; 1/3 little change in condition, but the preoperative use of dehydrating agents, hormones have been disabled. CONCLUSION: The dose of ~ (192) iridium reference point has the purpose of destroying the tumor without any adverse effect on the patients and effectively protects the normal brain. No recurrence or worsening cases have been found in one year after operation.