碘^(125)粒子支架植入联合化疗治疗晚期食管癌的临床观察

CLINICAL OBSERVATION OF INTRA-RADIATION STENTING WITH ^(125)I ALLIED CHEMOTHERAPY FOR TREATMENT OF ADVANCED ESOPHAGEAL CARCINOMA

目的探讨碘^(125)粒子支架植入联合化疗治疗晚期食管癌的临床疗效及不良反应。方法选取2008年1月一2011年1月收治的无根治机会的晚期食管癌15例,应用数字减影血管造影(digital subtraction angiography DSA)技术,透视下经口腔置入碘^(125)粒子食管支架。术后第7天开始行氟尿嘧啶+顺铂方案化疗,21d为1个周期,共完成4个周期(进展者换用多西紫杉醇+顺铂)。支架放置后1、3、6、12个月复查CT或MRI评估疗效,并记录相关不良反应发生情况。结果 15例患者,1个月复查所有病灶均有所控制,进食明显改善,3、6、12个月有效率分别为66.6%、53.4%、33.3%,1年总生存率为86.7%。未出现大出血、穿孔、感染、放射性肺纤维化等严重并发症。结论碘^(125)粒子支架植入联合全身化疗治疗晚期食管癌近期疗效显著,患者耐受性较好,是一种相对安全、有效的方法 。

Objective To discuss the clinical efficacy and side effects of intra-radiation stenting （^125I particle stent） for the treatment of advanced esophageal cancers. Methods Fifteen patients with advanced esophageal cancer who had no chance of radical cure were enrolled in this study. Under X-ray guidance the esophageal stent, which was tied up with ^125I radioactive particles, was orally inserted to the diseased region of the esophagus. After seven days, FP chemotherapy was in use, 4 cycles altogether （evolved TP exchange）. CT or MRI were checked to estimate curative effect at the end of 1 st,3rd,6th, 12th months,and the relevant side effects were observed. Results After the operation,all the tumor size was decreased at the end of first month, and clinical symptoms such as dysphagia showed an obvious improvement. Effective rates were 66.6% ,53.4% ,33.3% at the end of 3rd,6th, 12th months. Overall survival rate was 86.7% at the end of the first year. No serious complications such as hemorrhage ,tresis, infection etc occurred. Conclusion The intra-esophageal implantation of radioactive stent allied chemotherapy is a feasible and safe treatment for advanced esophageal cancers with excellent recent curative results.