Shaw C M, Sumi S M, Alvord E C, Gerdes A J, Spence A, Parker R G
J Neurosurg. 1978 Jul;49(1):1-12. doi: 10.3171/jns.1978.49.1.0001.
Various modes of therapy, alone or in combination, have had little effect in improving the survival of patients with glioblastoma multiforme. Recently, in a pilot study, 34 patients with glioblastoma were treated by fast-neutron-beam irradiation of the whole brain. Following treatment, the patients became steroid-dependent and pursued a gradual downhill course with increasing obtundation. Although there was no improvement in the length or quality of survival of these patients, neuropathological studies in the 13 patients who came to autopsy showed the following: 1) extensive coagulative necrosis of much of the tumor mass; 2) dense infiltration by collagenous connective tissue; 3) minimal phagocytic reaction; 4) marked reduction in the amount of viable tumor; 5) abnormal astrocytic proliferation, which may represent either astrocytoma or a radiation-induced bizarre gliosis, and 6) areas of gliosis and white matter degeneration in the brain stem, remote form the tumor site. These observations suggest that continued efforts to further refine this mode of therapy for glioblastoma are warranted.
单独或联合使用的各种治疗方式，对改善多形性胶质母细胞瘤患者的生存率几乎没有效果。最近，在一项初步研究中，34例胶质母细胞瘤患者接受了全脑快中子束照射治疗。治疗后，患者出现对类固醇的依赖，并随着意识障碍的加重而逐渐病情恶化。尽管这些患者的生存时长和质量没有改善，但对13例进行尸检的患者进行神经病理学研究发现如下情况：1）大部分肿瘤组织出现广泛的凝固性坏死；2）胶原结缔组织密集浸润；3）吞噬反应轻微；4）存活肿瘤数量显著减少；5）星形细胞异常增殖，这可能代表星形细胞瘤或辐射诱导的奇异胶质增生，以及6）在远离肿瘤部位的脑干出现胶质增生和白质变性区域。这些观察结果表明，有必要继续努力进一步完善这种针对胶质母细胞瘤的治疗方式。
