碘-125放射性粒子支架置入治疗食管癌的临床研究

The clinical research of radioactive particle stent with iodine-125 seeds in treatment of esophageal cancer

目的:探讨碘-125放射性粒子支架在治疗食管癌中的临床应用和疗效。方法:40例食管癌患者分为两组,A组20例应用带有碘-125放射性粒子的食管支架进行治疗,B组20例应用普通食管支架治疗。对患者术前及术后吞咽困难改善情况、体力状况评分(KPS评分)、并发症及生存期进行随访观察。结果:A、B两组支架均一次性置入成功。两组术后吞咽困难均较术前得到明显改善(P<0.05),两组术后1、2、3个月比较无显著性差异(P>0.05);两组术后KPS评分较术前得到明显改善(P<0.05),两组术后1、3个月比较差异亦有显著性(P<0.05);两组并发症发生情况无显著性差异(P>0.05);两组中位生存期分别为6.25个月和4.8个月(P<0.05)。结论:碘-125放射性粒子支架能够较长时间缓解患者吞咽困难,改善一般状况,并能有效地延长患者生存时间,安全性好,优于普通支架。

Objective ：To observe the clinical application and effect of iodine-125 seeds radioactive particle stent in esophageal cancer. Methods： Forty patients with esophageal cancer were divided into two groups. Group A of twenty patients were treated by radioactive particle stent with iodine-125 seeds ; Group B of twenty patients were treated by ordinary esophageal stent. The KPS, complications,dysphagia and survival time of patients were monitored before and after the operation. Results：Two groups of sent installations were very successful. The dysphagia was improved significantly in the two groups after the operation. There were notable differences in statistics between preoperation and postoperation （ P 〈 0. 05 ）, but there were no notable differences in statistics on dysphagia between Group A and Group B after the stent placement（ P 〉 0. 05 ）. KPS of all the patients were improved significantly after stent placement（ P 〈 0.05 ）, and the KPS was quite different after stent placement in both groups （ P 〈 0. 05 ）. There were no significant differences in complications between the two groups （P 〉 O. 05 ）. The median survival time was 6. 25 months and 4. 80 months in group A and group B, respectively. There were significant differences in statistics between the two groups（ P 〈 0. 05 ）. Conclusion：Radioactive particles stent with iodine-125 seeds can mitigate the symptoms of dysphagia and improve the conditions and greatly prolong the survival time of patient, so it has more security to patients and thus is superior to ordinary stent.