食管内支架置入术联合放射治疗晚期食管癌临床探讨

Clinical Research on Treatment of Esophageal Carcinoma in Advanced Stage by Metal Stent in Combination with Radiotherapy

目的:评价食管内支架置入术联合放射治疗晚期食管癌的临床可行性和疗效。方法:67例晚期食管癌伴狭窄患者分别行食管内支架置入术和支架联合放射治疗,比较食管内支架置入术组(A组)和食管内支架置入术联合放射治疗组(B组)患者的生存率和并发症发生率。结果:A组3、6、9、12个月的生存率分别为86.05%、67.53%、39.77%、14.71%;B组分别为87.49%、72.58%、53.14﹪、30.04%,两组差异无显著性(P=0.1562)。并发症总体发生率B组高于A组。A组再狭窄,返流性食管炎发生率明显高于B组(P<0.05)。结论:晚期食管癌伴狭窄患者支架置入术联合放射治疗未能明显提高生存率,但降低了狭窄和返流性食管炎的发生率。

Objective: To evaluate the clinical feasibility and effect on the treatment of esophageal carcinoma in advanced stage by metal stent in combination with radiotherapy. Methods: Sixty-seven patients with semi-stenotic esophageal carcinoma in advanced stage were performed the insertion of metal stent and insertion of endoprothesis in combination with radiotherapy. The survival and complication for the patients in group A (metal stent only) and group B (insertion of endoprothesis combined with radiotherapy) were compared. Results: The survival rates of 3, 6, 9 and 12 months in group A were 86.05%, 67.53%, 39.77% and 14.71%, respectively; in group B, they were 87.49%, 72.58%, 53.14% and 30.04%, respectively. There was no significant difference (P= 0.156). The gross incidence of the complication in group B was higher than in group A. The incidence of restenotic and backstreaming esophagitis in group A was overtly higher than in group B (P = 0.05). Conclusion: The treatment for the patients of esophageal carcinoma in advanced stage, with stenosis, by insertion of metal stent in combination with radiotherapy fails to increase the survivals significantly but can decrease the incidence of stenotic and backstreaming esophagitis.