125I覆膜分节粒子支架与传统支架治疗晚期食管癌的对比研究

Segmental covered stent loaded with 125I seeds versus conventional stent for the treatment of advanced esophageal cancers: a comparative study

目的比较125I覆膜分节粒子支架与传统普通支架治疗无法手术切除食管癌的生存期与并发症差异。方法回顾性分析25例经食管支架植入治疗的无法手术切除的食管癌患者,分为125I覆膜分节粒子支架组12例(粒子组)和传统普通支架13例(对照组),就两组术后生存期,再狭窄、移位及其他支架相关并发症进行对比研究。结果粒子组平均生存期为173(148~181) d,对照组平均生存期为94(67~190) d,两组比较差异具有统计学意义(P<0.05);粒子组再狭窄率(16.7%)对比对照组(23.1%)差异无统计学意义(P>0.05);但粒子组的移位率(33.3%)较对照组(7.7%)显著增高(P<0.05);125I覆膜分节粒子支架对比普通食管支架能显著延长患者生存期,未增加其他支架相关并发症情况,但一定程度上增加了移位率。

Objective To compare the survival time and complications of segmental covered stent loaded with 125I seeds with those of conventional stent in treating advanced esophageal cancers. Methods The clinical data of 25 patients with inoperative advanced esophageal cancer, who were treated with esophageal stent implantation, were retrospectively analyzed. The patients were divided into study group(n=12, receiving implantation of segmental covered stent loaded with125 I seeds) and control group(n=13, receiving implantation of conventional stent). The survival time, in-stent restenosis, stent displacement and other stent-related complications were calculated, and the results were compared between the two groups. Results The mean survival time(MST) of the study group and the control group were 173 d(148-181 d) and 94 d(67-190 d)respectively, the difference in MST between the two groups was statistically significant(P<0.05). The in-stent restenosis rates in the study group and the control group were 16.7% and 23.1% respectively, the difference in restenosis rate between the two groups was not statistically significant(P >0.05). The incidence of stent displacement in the study group was 33.3%, which was remarkably higher than 7.7% in the control group(P<0.05). No statistically significant difference in the other stent-related complications existed between the two groups. Conclusion In treating inoperative advanced esophageal cancers, segmental covered stent loaded with 125I seeds is superior to conventional stent in strikingly prolonging survival time of patients and not increasing the incidence of other stent-related complications, although the incidence of stent displacement is increased to a certain extent.