Seiler R W
Surg Neurol. 1979 Feb;11(2):97-100.
Five cases of recurrent malignant gliomas are reported. They showed unequivocal and long-lasting improvement of the clinical status and brain scintigram after progressive clinical and scintigraphic deterioration occurred during the initial courses of chemotherapy. The differential diagnosis of tumor regrowth and this unusual delayed response are discussed. Swelling of dead tumor cells and a secondary inflammatory reaction could explain the initial clinical deterioration. The delayed response may be consistent with the slow removal of dead cells from the brain. This has been observed experimentally. Evaluation of the response of a malignant glioma to chemotherapy should be made by serial observations during a sufficiently long period of time.
报告了5例复发性恶性胶质瘤病例。在初始化疗疗程中临床和脑闪烁扫描出现进行性恶化后，这些病例的临床状况和脑闪烁扫描显示出明确且持久的改善。讨论了肿瘤再生长与这种不寻常的延迟反应的鉴别诊断。死亡肿瘤细胞的肿胀和继发性炎症反应可以解释最初的临床恶化。延迟反应可能与从脑中缓慢清除死亡细胞一致。这已在实验中观察到。对恶性胶质瘤化疗反应的评估应通过在足够长的时间内进行系列观察来进行。
