内镜超声下植入化疗粒子治疗进展期胃癌的临床研究

Endoscopic ultrasonography-guided chemotherapeutic seeds implantation for progressive gastric cancer

目的 探讨超声内镜引导下5-FU化疗粒子植入治疗进展期胃癌的临床价值.方法 选择进展期胃癌病灶伴流出道梗阻的病例,在超声胃镜引导下进行多点植入5-FU化疗粒子45～60粒,平均注射5-FU化疗粒子100 mg,并进行治疗前后的病灶三维扫描.结果 23例患者共施行粒子植入治疗33次.内镜观察标准完全缓解1例,部分缓解15例,稳定6例,恶化1例.临床上缓解不全梗阻显著有效6例,明显有效7例,有效9例,无效2例,总有效率91.4%.结论 超声内镜引导下5-FU化疗粒子植入治疗进展期胃癌安全、可靠,并发症少.超声内镜三维扫描对化疗疗效的判断可作为一种新的评价方法.

Objective To evaluate the efficacy of endoscopic ultrasonography（EUS）guided implantation of 5-FU seeds for progressive gastric cancer.Methods A total of 23 patients with progressive gastric cancer and outflow obstruction were enrolled into the study.During the endoscopy procedure, 45-60 5-FU seeds were implanted into the tumors with guidance of EUS, with an average dose of 100 mg.Volumes of tumor were examined with 3D-EUS before and after the treatment.Results A total of 33 procedures of 5-FU implantation were performed.By measurements of 3D-EUS, the numbers of patients with complete respons, partial response, no change, progressive disease were 1, 15, 6 and 1, respectively.In terms of outflow obstruction improvement, significant effect, obvious effect and average effect were achieved in 6, 7 and 9 patients, respectively, with an overall response rate at 91.4%.Conclusion EUS-guided 5-FU seed implantation in progressive gastric cancer is safe,reliable and effective with few complications.3D-EUS may be a new method to evaluate curative effect.