介入法动脉灌注化疗结合放疗治疗中、晚期食管癌

Interventional Intra-Arterial Infusion Chemotherapy Combining with Radiotherapy in the Treatment of Advanced Esophageal Carcinoma

目的 探讨放疗结合动脉灌注化疗治疗中、晚期食管癌的临床应用价值 ,并发症的预防及治疗效果的评价。方法 对 3 0例中、晚期食管癌患者行放疗加超选择性食管供血动脉灌注化疗并随访 3～ 2 4个月 ,观察临床及放射学改善情况 ,评价治疗效果。结果 治疗后大部分患者临床指标明显改善 ,其中 10例行术前放疗加灌注化疗致肿瘤缩小后再行手术治疗 ,病检示癌巢中心明显坏死 ,间质纤维化和炎症细胞浸润等。结论 放疗结合经导管直接向肿瘤供血动脉灌注化疗药物 ,能增加局部的药物浓度和药物效应 ,减轻全身毒性反应 ,有效缩小局部肿块 ,是一种行之有效的综合治疗中、晚期食管癌的方法。

Objective To investigate the clinical value of radiotherapy combing with super selective esophageal intra arterial infusion chemotherapy in the treatment of advanced esophageal carcinoma and the prevention of complications. Methods Radiotherapy and super selective esophageal intra arterial infusion chemotherapy were used in 30 cases and the patients were followed up within 3 to 24 months. Results In most cases,the clinical symptoms improved obviously after treatment,and 10 cases were treated with operation because the tumor volume obviously decreased after preoperative radiotherapy and intra arterial infusion chemotherapy.Pathological examination of these cases showed center of the tumor nests necrosis,interstitial fibrosis,and inflammatory cell infiltration. Conclusion Radiotherapy combing with infusion chemotherapy into tumor supplying artery can increase local drug concentration,decrease toxic reaction of all over the body,and can also decrease the tumor volume.So it is an effective stratagem for advanced esophageal carcinoma.