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目的观察手术联合125I粒子植入治疗复发性高级别胶质瘤(WHO 3～4级)的临床效果。方法 46例复发性高级别胶质瘤患者随机分为手术联合125I粒子内放疗组(联合治疗组,25例)和单纯手术组(21例)进行治疗。术后定期随访,观察肿瘤复发情况及并发症。比较两组患者的生存时间和半年、1年、2年的生存率。结果联合治疗组的生存时间(68.3±5.46)周,高于单纯手术组〔(45.1±6.86)周,P<0.05〕,二者的半年生存率差异无统计学意义,1年和2年生存率联合治疗组高于单纯手术组(P<0.05)。联合治疗组的并发症高于单纯手术组,经对症处理后可有效缓解。结论手术联合125I粒子间质内放疗可有效地延长复发性高级别胶质瘤患者的生存时间,1年和2年生存率显著提高。
Objective To observe the clinical effect of operation combined with 125I seed implantation in the treatment of recurrent high grade gliomas (WHO grade 3 ~ 4). Methods Forty - six patients with recurrent high grade gliomas were randomly divided into operation combined with 125I intra - particle radiotherapy (combination therapy group, 25 cases) and operation alone group (21 cases). Regular follow-up after surgery to observe the recurrence of the tumor and complications. The survival time of two groups of patients and the survival rates of six months, one year and two years were compared. Results The survival time of the combined treatment group (68.3 ± 5.46) weeks was significantly higher than that of the simple surgery group (45.1 ± 6.86 weeks, P <0.05). There was no significant difference between the two groups in the one-year and two-year survival rates The rate of combined treatment group was higher than that of the simple operation group (P <0.05). The complications of the combined treatment group were higher than those of the simple operation group, which could be effectively relieved after the symptomatic treatment. Conclusions Surgery combined with 125I particle interstitial radiation therapy can effectively prolong the survival time of patients with recurrent high grade gliomas, and the 1-year and 2-year survival rates are significantly increased.