^125I粒子气管支架与普通气管支架治疗食管癌所致恶性气道梗阻的对照研究

Tracheal stent loaded with^125I seeds versus conventional tracheal stent for the treatment of malignant airway obstruction caused by esophageal cancer:a control study

目的比较^125I粒子气管支架与普通气管支架治疗食管癌所致恶性气道梗阻的有效性。方法回顾性分析2014年1月至2018年1月食管癌所致恶性气道狭窄行支架置入的患者46例,其中接受^125I粒子气管支架置入24例,接受普通气管支架置入22例。主要分析指标为总生存时间(OS),次要指标为技术成功率、气道狭窄程度、症状缓解、安全性。结果中位随访时间155 d(全距,15~270 d)。两组支架置入的技术成功率均为100%。支架置入后,^125I粒子支架组患者的平均狭窄程度由术前3.00下降到0.95,普通支架组由术前3.13下降到0.96(两组手术前后比较,P<0.001)。两组患者术后呼吸困难症状均得到明显缓解。^125I粒子支架组的患者mOS明显长于普通支架组(156 d比103 d,P=0.005)。两组的并发症发生率无显著差异(20.5%比27.3%,P=0.374)。结论^125I粒子气管支架置入治疗食管恶性气道狭窄技术可行、安全,相较于普通气管支架能延长患者总生存时间。

Objective To compare the curative effect of tracheal stent loaded with ^125I seeds with that of conventional tracheal stent in treating malignant airway obstruction caused by esophageal cancer.Methods From January 2014 to January 2018,tracheal stent implantation was performed in 46 patients with malignant airway obstruction caused by esophageal cancer.Of the 46 patients,implantation of tracheal stent loaded with^125I seeds was employed in 24(study group)and implantation of conventional tracheal stent was used in 22(control group).The main analytical index was overall survival(OS)time,and the secondary indexes included technical success rate,airway stenosis degree,improvement of symptoms and clinical safety.Results The median follow-up time was 155 days(ranging from 15 to 270 days).The technical success rate was 100%in both groups.After implantation of stent,the average degree of stenosis in the study group decreased from preoperative 3.00 to postoperative 0.95,while in the control group the average degree of stenosis decreased from preoperative 3.13 to postoperative 0.96(P<0.001).The symptom of dyspnea was improved in both groups.The median OS in the study group was 156 days,which was significantly longer than 103 days in the control group(P=0.005).No statistically significant difference in the incidence of complications existed between the two groups(20.5%versus 27.3%,P=0.374).Conclusion For the treatment of malignant airway obstruction caused by esophageal cancer,the implantation of tracheal stent loaded with ^125I seeds is technically feasible and clinically safe.Compared with conventional tracheal stent,the stent loaded with^125I seeds can prolong the OS time of patients.