Tsuboi K, Yoshii Y, Hyodo A, Takada K, Nose T
Department of Neurological Surgery, University of Tsukuba, Ibaraki, Japan.
J Neurooncol. 1995;23(3):223-31. doi: 10.1007/BF01059953.
Thirty cases of gliomas treated by surgery, radiotherapy and intra-arterial (IA) ACNU were reviewed with a focus on the late side-effect known as leukoencephalopathy. All cases were classified into three groups; remission (10 cases), regrowth (15 cases) and leukoencephalopathy (5 cases) from their outcome. The average total doses of IA ACNU were 49.8 mg/sqm body surface area in the remission group, 157.3 mg/sqm in the regrowth group and 203.1 mg/sqm in the leukoencephalopathy group. There were significant differences in the total IA ACNU doses between the remission group and both regrowth and leukoencephalopathy groups, while no significant differences were noticed in the dose of radiation given. There was a correlation between the total dose of IA ACNU and the occurrence of leukoencephalopathy. An autopsy of a typical case of leukoencephalopathy revealed various degrees of myelin breakdown and thickening of arterial walls, which probably manifested progressive dementia accompanied by urinary incontinence and gait disturbance.
对30例接受手术、放疗及动脉内（IA）注射阿糖胞苷治疗的神经胶质瘤患者进行了回顾性研究，重点关注称为白质脑病的晚期副作用。根据治疗结果，所有病例分为三组：缓解组（10例）、复发组（15例）和白质脑病组（5例）。IA注射阿糖胞苷的平均总剂量在缓解组为49.8mg/平方米体表面积，复发组为157.3mg/平方米，白质脑病组为203.1mg/平方米。缓解组与复发组和白质脑病组之间IA注射阿糖胞苷的总剂量存在显著差异，而放射剂量未观察到显著差异。IA注射阿糖胞苷的总剂量与白质脑病的发生之间存在相关性。对一例典型白质脑病病例的尸检显示，存在不同程度的髓鞘破坏和动脉壁增厚，这可能表现为进行性痴呆，并伴有尿失禁和步态障碍。
