Study on treatment of malignant glioma with reference to IORT using radiosensitaizers.

(1)实验研究了CDDP对A172和T98G肿瘤细胞系的放射治疗效果。在单细胞凝胶电泳（SCG）评价中，CDDP照射对肿瘤细胞的杀伤作用明显强于不加CDDP的照射。(2)为了评价人恶性胶质瘤的放射敏感性，除增殖细胞核抗原（PCNA）、mb -1和p53的免疫反应性外，还进行了SCG检测。对22例患者的结果进行统计分析，并与临床结果进行比较：SCG检测中DNA损伤细胞（DNA损伤指数：DDI）的范围为10.5 - 37.2%，因此在初始治疗后早期，较低的DDI百分比导致肿瘤复发。p53积累的患者ddi和肿瘤复发率均显著增高，而越年轻患者ddi和肿瘤复发率越低（p<0.01）。(3)分析了CDDP对27例恶性t胶质瘤的放疗效果。结果1年生存率为72.6%，2年生存率为35.3%。(4)高级别（3级和4级）胶质瘤患者接受额外的术中放射治疗（IORT），分析其生存与肿瘤免疫细胞化学评估的关系。在54例选择的高级别胶质瘤患者中，11例在初始治疗后长期生存超过5年。回顾性分析与延长生存期相关的临床病理特征为：(1)癫痫发作，(2)初始CT扫描显示小肿块，未增强，随访时发展为增强的大肿块，(3)肿瘤位置经常位于额部和靠近皮质表面，(4)IORT中20-30Gy的照射（平均25.5Gy）分一部分照射到术后肿瘤床，(5)低PCNA标记指数（LI）。另一方面，分析IORT治疗复发性幕上低级别胶质瘤的疗效。在38例经组织学证实的幕上低度微光的12例成人患者中，有6例接受了IORT。2年生存率为83.3%，显著高于对照组。少

(1) Effectiveness of CDDP on raidotherapy was experimentally investigated in A172 and T98G tumor cell line. In the evaluation of single cell gel electrophoresis (SCG) assay, irradiation with CDDP resulted in significantly stronger killing effect on the tumor cells than that without CDDP.(2) To evaluate the radiosensitivity of human malignant gliomas, SCG assay in addition to the evaluations of proliferating cell nuclear antigen(PCNA), MIB-1 and p53 immunoreactivity were undergone. Those result in 22 patients was statistically analyzed, compared with clinical outcome : DNA-damaged cells on SCG assay (DNA damage index : DDI) ranged from 10.5 to 37.2%, thus, lower percentage DDIs resulted in tumor recurrence in the earlier periods after the initial treatment. In patients with accumulation of p53, DDIs and tumor recurrence rate were significantly higher but lower in younger, respectively (p<0.01).(3) Effectiveness of CDDP on radiotherapy was clinically analyzed in 27 patients with malignan … More t gliomas. In the results, the survival rate was 72.6% in 1-year and 35.3% in 2-year.(4) Patients with high grade (grade 3 and 4) gliomas who were given additional intraoperative radiation therapy (IORT) were analyzed survival in relation to the immunocytochemical assessment of their tumors. Of 54 selected patients with high grade gliomas, 11 had long-term survival over 5 years after the initial treatment. The clinico-pathological features, analyzed retrospectively, that were associated with prolonged survival were : (1) epileptic seizures, (2) initial CT scans showing a small mass without contrast enhancement which developed into an enhancing larger mass on follow up, (3) tumor location which was frequently frontal and near the cortical surface, (4) 20-30Gy irradiation (mean 25.5Gy) in IORT delivered in one fraction to the post-resection tumor bed, and (5) a low PCNA labelling index (LI). On the other hand, effectiveness of IORT for recurrent supratentorial low grade glioma was analyzed. Of twelve adult patients in the records of 38 patients with histologically verified supratentorial low grade glima, six underwent IORT.The 2-year survival rate was 83.3% and significantly higher. Less