金属内支架置入并放化疗治疗食管癌性狭窄临床疗效观察

Metallic Stent Implantation with Radiotherapy and Chemotherapy for the Treatment of Esophageal Cancerous Stricture

目的 评价金属内支架置入并放化疗治疗食管癌的临床效果。材料与方法 放化疗组 3 5例中 ,男 19例 ,女 16例。年龄45～ 76岁 ,平均 66岁。病程 1～ 16个月 ,平均 6个月。全部病例经食管镜或病理确诊为食管癌并置入内支架后行放化疗。 3 1例放疗 ,剂量DT60～ 70Gy/6～ 7周 ,4例经胃左动脉灌注顺铂 2 0 0mg ,阿霉素 60～ 70mg ,5 氟尿嘧啶 10 0mg。对照组 3 5例中 ,男 2 1例 ,女 14例。年龄 45～ 75岁。病程 1～ 18个月 ,平均 6.5个月。结果 食管癌置入内支架放化疗随访观察 ,食管内支架通畅时间 1～ 5年者占 2 0 % ,再狭窄率为 48% ,比未放化疗食管癌置入支架组通畅时间长 ,再发狭窄率低。结论 中晚期食管癌置入内支架后进行放化疗能有效地防止再狭窄 。

Objective To evaluate metallic stent implantation with radio and chemotherapy in treating esophageal cancerous stricture.Materials and Methods Stent implantation, radiotherapy and chemotherapy were adopted in 35 patients with endoscopically or pathologically proved esophageal cancer, including 19 males and 16 females, aged 45～76 years (mean 66), with an illness duration of 1～16 months (averaged 6 months). Thirty one cases received radiotherapy with the dosage of DT 60～70Gy/6～7 weeks. Four cases received chemotherapy with Cisplatin 200mg, Adriamycin 60～70mg, 5 Fluoroucacil 100mg infused via left gastric artery. The control group consisted of 35 patients, including 21 males and 14 females, aged 45～75. The duration of illness was 1～18 months (mean 6.5 months).Results A following up period of 1～5 years showed that in study group 20% of stents remained patent, and restenosis occurred in 48%. The above results were better than that obtained in the control patients treated with stent implantation alone.Conclusion Stent implantation together with radiotherapy and chemotherapy is very effective for the treatment of esophageal stricture due to intermediate or advanced esophageal carcinoma.