【摘要】 目的 报告14例脑胶质瘤在脑立体定向仪引导下永久性放射性植入粒子后的临床及影像学变化。探讨125I粒子对脑胶质瘤治疗作用及生物学特点。方法 2002年10月～2004年10月，利用MICK200-TPV放射性粒子植入系统，对14例脑胶质瘤患者在脑立体定向仪引导下直接植入125I粒子，植入粒子5～14颗，每颗粒子活度0.3～0.4mCi，病灶周边剂量60～90Gy。6例植入粒子后补充外放疗35～40Gy。结果 全组14例获得6～24个月的随访，中位12个月。治疗后1个月CT或MRI复查14例残余病灶缩小，与周围组织分界清楚；治疗后12个月CT或MRI显示11例粒子聚集，病灶明显缩小或消失；治疗后临床症状和体征均得到缓解，7例治疗后1～2个月临床症状和体征消失。结论 在脑立体定向仪引导下直接植入125I粒子治疗脑胶质瘤，能够对肿瘤及肿瘤周边可浸润范围提供较高的治疗剂量，达到控制和治愈肿瘤的目的。

    【关键词】 胶质瘤；放射性粒子；立体定向技术；永久性植入

    Treatment of brain glioma with permanent implantation of radioactive seeds by brain stereo orientation technology

    HAO Chuan-guo,FU Peng,XIN Chang-ming,et al.

    Radiotherapy Center,Neurosurgery of Taian Central Hospital,Taian 271000,China

    【Abstract】 Objective To review the change of the clinical and image in 14 patients with brain glioma who permanent implantation of 125Ⅰ seeds led by stereo orientation head unit,and analyzed the effectiveness of 125I and the characteristic of biology.Methods From Oct.2002 to Oct.2004,with the system of MICK 200-TPV radioactive seeds implantation.The 125Ⅰ seeds were direct implanted into 14 patients with brain glioma led by the apparatus of stereo orientation head unit.The number of seeds was 5～14.The activity of per seed was 0.3～0.4mCi.The peripheral radiation total dose was 60～90Gy.6 patients were superadded radiotherapy(the doses was 35～40) after the seeds implantation.Results The median follow time was 12 months (range 6～24 months).After 1 month examined by CT or MRI,the focuses of 14 cases had been shrunk,the line of demarcation with the tissue of surrounding was clear.After 12 months,the 11 focuses were assembled with seeds that had been decreased evidently or disappeared.The symptom of all had been mitigated.The symptom of 7 cases had been disappeared after 1～2 months.Conclusion Implantation of 125Ⅰ seeds can heighten the radioactive dose for the brain glioma.May control and mend the brain glioman. ......