晚期食管癌内镜下综合治疗的价值

Evaluation of comprehensive treatment in patients with unresectable esophageal carcinoma under endoscopy

目的评价晚期食管癌内镜下综合治疗的价值。方法通过对68例晚期食管癌患者随机对照研究,比较内镜下综合治疗组与单纯支架置入组生存时间、生活质量、并发症情况。结果单纯支架置入组与综合治疗组相比,治疗后的吞咽功能分级、KPS评分差异无统计学意义,再狭窄发生率分别为12/32和3/36,差异有统计学意义(P＜0．01)；两组病人生存时间的比较经秩和检验(282±41)d和(346±53)d(P=0．072),生存时间的比较无统计学差异,但呈现了较强的延长趋势。结论内镜下综合治疗晚期食管恶性肿瘤降低了再狭窄的发生率,并适度延长了生存期。

Objective ： To evaluate the benefits of comprehensive treatment in patients with unresectable esophageal carcinoma under endoscopy. Methods： Sixty-eight patients with unresectable esophageal carcinoma were randomly divided into two groups ： patients in group A （ n = 32 ） were treated with stenting alone , and those in group B （ n = 36 ） were treated with comprehensive treatment including radiofrequency ablation, injection of chemotherapeutic drugs and stenting under endoscopy followed by radiotherapy and/or chemotherapy. Comparison： was made by assessing their survival time, quality of life （QOL）, degree of dysphagia, and complications. Results： There was no statistically significant improvement in dysphagia and QOL between the two groups. Although there was no difference in the frequency of stenting-related complications, re-stenosis occurred much less frequently in group B patients （P 〈0.01 ）. The mean survival time of patients was 282 ±41 days and 346±53 days in group A and group B respectively. There was no significant difference between the two groups （ P = 0. 072 ）. Conclusion Besides decreased recurrence of stenosis, post-stenting radiotherapy and/or chemotherapy does not provide additional benefits for survival, although there is the significant extension of life span in group B.