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Clinical and immunological analysis of the efficiency of combined immunotherapy with the use dendritic cells for the treatment of malignant glioma of the brain was carried out. Dendritic cells generated in the presence of granulocyte-macrophage CSF and IFN-alpha retain their functional characteristics in patients with gliomas, which suggests the possibility of their use for the treatment of malignant tumors (glioma) of the brain. Combined therapy using interferon-induced dendritic cells was associated with generation of antigen-specific immune response during vaccinations. The results indicate satisfactory tolerance of combined immunotherapy using dendritic cells and the absence of toxic side effects at the stage of adoptive immunotherapy and at the stage of vaccinations with dendritic cells. Clinical trials showed that vaccinations with dendritic cells included into combined immunotherapy improved the quality of life and survival of patients with malignant gliomas.

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Опухоли спинного мозга составляют от 1,4 до 10,0 % всех опухолей цен-тральной нервной системы [1,10]. Сре-ди первичных опухолей преобладают экстрамедуллярные, которые встре-чаются в 70-90 % случаев от общего числа данных видов новообразований. Частота встречаемости экстрамедул-лярных опухолей (ЭМО) составляет 1,3 случая на 100 000 населения в год [2,10,13].Накопленный опыт хирургическо-го лечения ЭМО указывает на высокую эффективность этого метода. Но суще-ствует ряд проблем в лечении паци-ентов с ЭМО. Одной из них является хирургия опухолей с интраэкстрака- Objective. To analyze long-term clinical results of using neodymium laser for surgical treatment of patients with spinal dumbbell-shaped tumors. Materials and Methods. Clinical material is based on results of surgical treatment in 83 patients (49 females and 34 males) with dumbbell-shaped tumors. The patients were divided into two groups depending on the tumor resection technology: 57 patients (control group) were operated on using conventional neurosurgical technique, and 26 (study group) -using laser radiation with a wavelength of 1.064 mkm. Results. In the study group good long-term results were achieved in 10 patients (38.5 %), satisfactory -in 12 (46.1 %), and poor -in 4 (15.4 %). In the group of conventional technology of the tumor removal, good results were achieved in 10 patients (17.5%), satisfactory -in 27 (47.4 %) and poor -in 20 (35.1 %). Conclusion: The use of a neodymium laser for removal of dumbbell-shaped tumors allows achieving higher levels of radical resection with a possibility of one-stage removal of intracanal and paravertebral fragments of the tumor with minimally injurious exposure of the spinal cord and its roots.

The problem of search and development of new approaches to integrated treatment of patients with malignant brain glioma remain one of the most urgent issues for contemporary neurosurgery and neurooncology. In spite of the applied efforts the results of a complex therapy for malignant glioma, especially for glioblastoma, are utterly unsatisfactory. Immunotherapy is one of the directions searching for a generation of cytotoxic cells able to lyse the tumor. Combination of various immunotherapeutic approaches is regarded the most perspective way. Since 1999 Neurosurgical Clinic of Novosibirsk Research Institute of Traumatology and Orthopaedics was carrying out clinical trials of combined immunotherapy within complex therapy of patients with malignant brain glioma in compliance with two protocols.