内镜下化疗粒子植入缓解上消化道癌性梗阻的疗效观察

Therapeutic effect of endoscopic chemotherapeutic slow-releasing ion implantation on carcinomatous obstruction in upper digestive tract

目的 初步评价内镜下化疗缓释粒子瘤内植入治疗上消化道恶性梗阻的近、远期临床疗效.方法 内镜下对我院2008年3月-2013年5月7例晚期恶性肿瘤患者肿瘤梗阻部结节及浸润处多点植入缓释化疗粒子,3例胃癌患者行5-FU粒子植入,平均注射5-FU缓释粒子148 mg;4例食管癌患者行顺铂粒子植入,平均注射顺铂缓释粒子48 mg.结果 7例患者共施行粒子植入治疗9次,未发生出血、穿孔等并发症;肝、肾功能及血常规检查未见异常.缓解不全梗阻显著有效1例,明显有效3例,有效2例,无效1例,总有效率85.7％;1次治疗后症状缓解持续时间平均约20 d;7例中,6例死亡,生存期为2～8个月,平均存活时间约112 d.结论 内镜下化疗粒子植入对晚期上消化道恶性梗阻患者有较好的姑息性治疗效果,是治疗晚期上消化道癌性梗阻可选择的手段.

Objective To assess the short-and long-term effect of endoscopic chemotherapeutic slow-releasing ion implantation on carcinomatous obstruction in upper digestive tract.Methods Of the 7 patients with advanced cancer admitted to our hospitalfrom March 2008 to May 2013 for endoscopic implantation of chemotherapeutic slow-releasing ions into their carcinomatous obstruction and infiltration sites,3 who were diagnosed was gastric cancer underwent 5-FU ion （148 mg） implantation and 4 who were diagnosed with esophagus cancer patients underwent cisplatin ion （48 mg） implantation.Results Seven patients received 9 times of slow-releasing ion implantation,during which no hemorrhage or perforation occurred,and their hepatic and renal function and blood routine examination were normal.The therapeutic effect endoscopic chemotherapeutic slow-releasing ion implantation was very significant in 1 patient,significant in 3 patients,good in 2 patients and poor in 1 patient,with a total efficiency of 85.7%.The average sustained symptom-relieving time was 20 days after once of treatment.Of the 7 patients,6 died with a survival time of 2-8 months （mean 112 days）.Conclusion Endoscopic chemotherapeutic slow-releasing ion implantation is a choice of treatment for carcinomatous obstruction in patients with advanced upper gastric cancer.