术中种植放射性籽源预防进展期食管癌根治术后复发的临床研究

Radioactive seed implantation prevents postoperative recurrence of radical resection of advanced esophageal cancer

目的:探讨术中将放射性碘125(125Ⅰ)粒子植入瘤床对预防进展期食管癌根治术后复发的疗效。方法:对2009年1月至2011年12月124例进展期食管癌患者采用手术切除联合术中125Ⅰ粒子植入或联合放疗的治疗方法。将124例患者分为两组,实验组:男48例,女14例;年龄(58.2±1.3)岁,采用根治手术+术中植入125Ⅰ治疗;对照组:男47例,女15例,年龄(59.1±1.5)岁,采用根治手术+术后放疗治疗。观察两组患者治疗时间、并发症发生率、局部复发和远处转移率。两组患者均获随访,随访时间l～3年。结果:实验组的治疗时间短于对照组;实验组的并发症发生率、局部复发率及3年生存率均低于对照组(P<0.05);实验组的远处转移率与对照组相比,差异无统计学意义。结论:术中种植放射性籽源预防进展期食管癌根治术后复发方法简单、使用安全、并发症少,治疗周期短,可预防或控制术后肿瘤的局部复发,提高患者的无瘤生存时间和3年生存率。

Objective：To evaluate the efficacy of radioactive seed implantation on preventing the postoperative recurrence of radical resection of advanced esophageal cancer.Methods：A prospective cohort study on 124 patients was carried out between Jan 2009 and Dec 2011.They were divided into two groups：the experimental group including male 48 cases,female 14 cases,average age 58.2 ±1.3,received radical resection plus 125Ⅰ radioactive seeds implantation;the control group including male 47 cases,female 15 cases,average age 59.1±1.5,received radical resection plus postoperative radiation therapy.Treatment time,complications,local recurrence and distant metastasis rate were observed.Two groups of patients were followed-up 1 ~3 years.Results： Treatment time of the experimental group was shorter than that of the control group;complications,local recurrence rate and 3 year survival rate of the experimental group were lower than those of the control group（P0.05）;There was no significant difference between two groups in distant metastasis rate.Conclusion：125Ⅰ radioactive seed implantation combined with radical resection is a simple,safe and effective method for advanced esophageal cancer,which may reduce local recurrence and improve survival rate.