Miyagami M, Tsubokawa T
Dept. of Neurological Surgery, School of Medicine, Nihon University.
Gan To Kagaku Ryoho. 1990 Aug;17(8 Pt 1):1447-53.
54 cases of malignant gliomas in adults localized in cerebral hemisphere including the location of basal ganglia and corpus callosum in 26% were survived over one month and followed more than 2 years after operation for 10 years recently. Histologically they had 40 cases of glioblastoma multiforme and 14 cases of anaplastic astrocytoma. All malignant gliomas were given an operation and radiation, classifying 4 groups due to chemotherapeutic methods; Group I (20 cases) was treated by intraarterial infusion of ACNU with 20% mannitol. The others were Group II (8 cases) treated by intraarterial infusion of ACNU only, Group III (13 cases) by intravenous infusion of ACNU only and Group IV (13 cases) by no chemotherapy. Post-operative survival rates in the malignant gliomas of Group I were that 1 year survival rate was in 16 out of 20 cases (80%), 2 years in 55%, and 5 years in 25%. In glioblastoma multiforme, 1 year survival rate of Group I was recognized in 70% and 2 years in 36%, a little better than the other treatments. 2 year survival rate of other treatments demonstrated 17% in Group II, 25% in Group III, and 11% in Group IV. CT findings of glioblastoma multiforme in Group I showed no rest tumor in 4 cases and one case of CR, and 3 cases of PR in the follow up study of 10 cases with rest tumor on CT after operation. There were no permanent complications except for temporary mild neurological deficit in 7% of Group I improving within 2 to 3 days after intraarterial infusion of ACNU and 20% mannitol. It is suggested that chemotherapy of Group I by intraarterial infusion of ACNU and 20% mannitol demonstrated a little better therapeutic efficacy than the other Groups, at least within 2 years after operation.
54例成人恶性胶质瘤位于大脑半球，包括基底节和胼胝体部位（占26%），近期有10例术后存活超过1个月并随访2年以上，最长达10年。组织学上，多形性胶质母细胞瘤40例，间变性星形细胞瘤14例。所有恶性胶质瘤均接受手术和放疗，并根据化疗方法分为4组；I组（20例）采用动脉内灌注阿糖胞苷（ACNU）联合20%甘露醇治疗。其他组分别为：II组（8例）仅采用动脉内灌注ACNU治疗，III组（13例）仅采用静脉内灌注ACNU治疗，IV组（13例）未进行化疗。I组恶性胶质瘤术后生存率为：1年生存率20例中有16例（80%），2年生存率为55%，5年生存率为25%。在多形性胶质母细胞瘤中，I组1年生存率为70%，2年生存率为36%，略优于其他治疗组。其他治疗组的2年生存率分别为：II组17%，III组25%，IV组11%。I组多形性胶质母细胞瘤的CT表现为：术后随访10例有残留肿瘤的患者，4例无残留肿瘤，1例完全缓解（CR），3例部分缓解（PR）。I组除7%患者在动脉内灌注ACNU和20%甘露醇后2至3天出现短暂轻度神经功能缺损且无永久性并发症外，无其他永久性并发症。提示I组采用动脉内灌注ACNU和20%甘露醇的化疗方法至少在术后2年内疗效略优于其他组。
