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术中荧光素引导下胶质母细胞瘤的显微手术切除:一项回顾性评估

[Microsurgical resection of glioblastoma guided with intraoperative fluorescein: a Retrospective evaluation].

作者信息

García-Corrochano Pamela, Castañeda Carlos A, Orrego Enrique, Deza Pedro, Heinicke Hugo, Casavilca Sandro, Castillo Miluska, Cortez Karen, Belmar Carolina, Dolores Ketty, Flores Claudio, Ojeda Luis

机构信息

Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú

Oncosalud, AUNA, Lima, Perú

出版信息

Rev Peru Med Exp Salud Publica. 2015 Jul-Sep;32(3):471-8.

Abstract

OBJECTIVES

To evaluate the influence of the use of sodium fluorescein (FLS-Na) in surgery of glioblastoma (GB) on the degree of tumor resection and survival in patients treated at the National Institute of Neoplastic Diseases.

MATERIALS AND METHODS

A total of 238 cases of GB treated between 2008 and 2013 were reviewed and 150 cases of GB who underwent surgical resection with clinicopathological information and adequate follow-up were selected.

RESULTS

The mean age was 51 years, 58.7% of the cases presented a Karnofsky score of at least 90. FLS-Na was administered in 80 cases (53.3%) and a subtotal and total resection was obtained in 69 (46%) and 81 (54%) cases, respectively. The group that received FLS-Na obtained higher rates of total resection than the group operated with white light alone (77.5 vs 27.1%, p<0.001). The median overall survival (OS) was higher in the group subject to total compared to subtotal resection (17 vs 7 months, p<0.001). The median OS in those who received FLS-Na was higher than in those who did not (15.0 vs 8 months, p=0.003). Other factors affecting OS were age (p=0.002), the Karnofsky score (p=0.052) and radiation therapy (p=0.016) and chemotherapy (p=0.011).

CONCLUSIONS

The microsurgical technique with administration of FLS-Na was associated with an increase in the rate of total resection and survival.

摘要

目的

评估在国立肿瘤疾病研究所接受治疗的胶质母细胞瘤(GB)患者手术中使用荧光素钠(FLS-Na)对肿瘤切除程度和生存率的影响。

材料与方法

回顾了2008年至2013年间治疗的238例GB病例,并选择了150例接受手术切除且具有临床病理信息和充分随访的GB病例。

结果

平均年龄为51岁,58.7%的病例卡诺夫斯基评分至少为90分。80例(53.3%)使用了FLS-Na,分别有69例(46%)和81例(54%)实现了次全切除和全切除。接受FLS-Na的组全切除率高于仅使用白光手术的组(77.5%对27.1%,p<0.001)。全切除组的中位总生存期(OS)高于次全切除组(17个月对7个月,p<0.001)。接受FLS-Na者的中位OS高于未接受者(15.0个月对8个月,p=0.003)。影响OS的其他因素包括年龄(p=0.002)、卡诺夫斯基评分(p=0.052)、放射治疗(p=0.016)和化疗(p=0.011)。

结论

使用FLS-Na的显微手术技术与全切除率和生存率的提高相关。

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