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^(125)I支架放疗联合小剂量化疗治疗晚期食管癌疗效分析 被引量:5

Effectiveness of self-expendable stent with Iodine-125 seeds on advanced esophageal cancer
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摘要 目的观察125I支架放疗联合小剂量化疗对晚期食管癌的疗效。方法选取该院同意该治疗方案的符合条件的54例晚期食管癌患者作为研究对象,随机分为125I放疗支架组(对照组)和125I放疗支架联合小剂量化疗组(联合组),各27例。根据术前CT及胃镜等结果确定放疗粒子排列情况,放疗粒子支架同普通支架置入,联合组在对照组基础上加小剂量5-Fu+顺铂静脉滴注。随访并记录两组患者的症状改善情况、血常规、支架移位情况、125I粒子是否脱落、CT观察病变范围的变化及食管有无穿孔、瘘及出血并发症等。结果所有支架均释放到位,释放过程顺利,释放过程中未出现碘-125粒子脱落现象,置支架后患者进食困难症状完全缓解。部分患者疼痛症状明显,使用止痛药物后3~15 d缓解。个别患者需要肌注吗啡或哌替定止痛。联合组中位生存时间为14.8个月。对照组中位生存时间为9.7个月。两组比较,联合组患者的平均生存期明显长于对照组(P<0.05)。但联合组白细胞下降、恶心、呕吐及肝功能异常发生率均明显高于对照组,差异有显著性(P<0.05)。结论125I支架放疗联合小剂量化疗治疗晚期食管癌能延长患者生存期,但部分毒副反应增多。 [Objective] To investigate the role of self-expandable stent with Iodine-125 seeds combined low dose chemotherapy on advanced esophageal cancer. [ Methods ] The eligible 54 advanced esophageal cancer pa- tients in the hospital were randomly divided into Iodine-125 radiation stent group (control group) and Iodine-125 ra- diation stent combination with small dose of chemotherapy group (combination group), 27 cases each. According to the results of preoperative CT and gastroscope to determine radiation particle arrangement situation, the radiotherapy particles stent was placed with ordinary stents, in combination group small dose of 5-Fu + cisplatin intravenous drip was used based on the control group. The improvement of symptoms, blood routine, stent shift, whether 125-I parti- cle was off, lesions range, change in CT, esophageal punched, fistula and bleeding complications were followed-up and recorded. [Result] All stents were released in place, and the release process was smoothly, no iodine - 125 particle falls off, After inserting a stent in patients, the difficulty in feeding was complete remission. Part of the pa- tients with pain symptoms, 3 - 15 d ease after use of analgesic drugs, Individual patients need muscle inject mor- phine or dolantin for pain. Median survival time of combination group and control group was 14.8 and 9.7 months respectively, There was a significant difference between the two groups. But in the combination group, white blood cell loss, nausea, vomiting and the incidence of abnormal liver function were significantly higher than those in the control group. [ Conclusion ] 125-I stent radiation therapy combination with low dose of chemotherapy in the treat- ment of advanced esophageal cancer can prolong patient survival, but part of those can increase adverse reaction.
作者 文美玲
出处 《中国内镜杂志》 CSCD 北大核心 2013年第9期941-944,共4页 China Journal of Endoscopy
关键词 ^125I支架 食管癌 小剂量化疗 self-expendable stent with Iodine-125 seeds esophageal cancer low dose of chemotherapy
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