中晚期食管癌术前选择性动脉灌注化疗的临床观察

Clinical observation of preoperative selective intra-arterial infusion chemotherapy in advanced esophageal carcinoma

目的观察中晚期食管癌外科手术前选择性动脉灌注化疗的临床疗效、病理变化和对手术治疗的影响,探讨食管癌术前选择性动脉灌注化疗的临床意义。方法22例病灶长度≥5cm的食管癌病人,外科术前对相应食管癌选择性造影并灌注化疗药物,比较病灶长度的变化,结合术中所见及术后病理学改变,观察其疗效。结果22例介入治疗后,病灶长度有不同程度缩短,其中完全缓解(CR)3例(13.6%),部分缓解(PR)11例(50.0%),稳定(S)8例(36.4%)。手术切除18例,切除率81.8%,组织病理发现癌组织变性坏死。结论术前选择性动脉灌注化疗有助于提高中晚期食管癌手术切除率,且并发症较少,是食管癌综合治疗的有效方法。

Objective To observe the clinical and pathological changes of advanced esophageal carcinoma treated with preoperative intra - arterial infusion chemotherapy, and the influence of this treatment on operation, and then to explore its clinical significance. Methods Twenty- two patients with advanced esophageal carcinoma whose lesions ≥5 cm were underwent selective gastric angiography and chemotherapeutic infusion before surgicaloperation, and then we compared the changes of lesions and observed the efficiency by clinical and pathologic analysis. Results The lengths of lesions were shortened in different degree. Among the 22 patients, complete relieve （CR） in 3 patients （13.6%）, partial relieve （PR） in 11 patients （50%）, stabiliza- tion （S） in 8 patients （36.4%）. 18 out of 22 cases were unden^ent the operation, and the resection rate was 86.4%. The histopathology showed the degeneration and necrosis of cancerous tissues. Conclusion Preoperative selective intra- arterial chemotherapy may be helpful for increasing the resection rate and have few complications. So, it may be an effective treatment to the advanced esophageal carcinoma.