食管支架腔内放射治疗的临床应用

Esophageal stent in clinical intracavity radiotherapy

大多食管癌患者只有在晚期出现进食梗阻时才就诊被发现,此时已失去手术机会,食管支架的置入虽然能快速缓解患者吞咽困难的症状,但对肿瘤组织并没有抑制作用,因此放射疗法在其治疗中扮演着非常重要的角色。随着技术的发展,食管癌放疗由原来单纯的体外放疗发展到现在的体外、腔内等多种形式的放疗,近年来食管内照射支架在临床应用越来越广泛。其具有疗效显著,使用方便和副作用小等优点。125I作为一种低能放射性粒子已被广泛用于多种肿瘤的治疗,也是食管内照射支架最常用的放射性粒子。文章就食管癌的治疗方式、食管癌外放射治疗与腔内放射治疗的优缺点、125I粒子捆绑支架治疗食管癌的应用情况及放射性粒子置入剂量的确定等问题进行了探讨。

Esophageal carcinoma is frequently diagnosed when the patient feels dysphagia. It is always at advanced stage and the best time of surgery has missed. Although esophageal stent could rapidly attenuate symptoms of dysphagia, it does not inhibit tumor tissues. Radiotherapy plays an important role in the treatment. With developing technology, radiotherapy has improved from in vitro therapy alone to in vitro and intracavity, etc. Recently, esophageal stent has been widely used in clinic. It is effective, convenient with little side effect. 125I as a kind of low-energy radioactive particle has been extensively used to treat various tumors; it is a common particle used for esophageal stenting. This paper discussed treatment of esophageal carcinoma, in vitro radiotherapy and intracavity radiotherapy, 125I brachytherapy and dose of radioactive particles.