内支架结合放疗治疗晚期食管癌18例临床分析

TREATMENT OF LATE STAGE ESOPHAGEAL CARCINOMA BY STENT IMPLANTATION

目的 通过被覆支架治疗晚期食管癌恶性狭窄 ,并行术后放射治疗 ,以提高生活质量 ,延长生存期。方法 晚期食管癌恶性食管狭窄 18例 ,狭窄直径均在 2 .5mm以下 ,其中 3例呈梗阻状 ,4例合并有食管瘘 ,1例出现肝部转移。经口置入镍钛合金被覆支架 2 0枚 ,于 2周后行外照射 ,肿瘤试剂照射剂量 (DT) :6 0～ 70Gy。结果 所有患者均一次顺利完成支架置入 ,患者进普食顺利 ,疗效满意。 2周后均顺利接受放射治疗 ,未出现并发症。经随访复查 ,支架未发生移位及出现再狭窄改变 ,食管通畅 ,患者进食顺利 ,生存期延长 ,平均 11个月。结论 被覆支架治疗晚期食管癌恶性食管狭窄及术后结合放疗 ,能有效地抑制肿瘤生长 ,提高生活质量 ,延长生存期 ,是治疗晚期食管癌患者的一种安全有效的治疗方法。

Objective\ To treat patients of esophageal carcinoma with malignant stenosis through covered stainless sleel stent implantation with radiotherapy. Methods\ 18 cases of advanced esophageal cancer with lumen stenosis less than 2.5 mm in diameter. Three of them had complete obstruction and 4 with fistula.Twenty nitinol stents were inserted to the site of senosis and then radiotherapy of 60 Co(DT 60～70 Gy) was given two weeks later. Results\ All of the patients were treated with the self-expanding stent successfully. The effect was excellent, the patients could swallow smoothly. All of the patients were radiotherapy two weeks after stent placement. No complications occurred. The postradiotherapy follow-up showed that all the patients could take foll diet. No narrowing recurrence occurred. The average servival time was 11 months. Conclusion\ The covered stainless sleel stent placement with radiotherapy is a safe and effective therapy for the helpful in the treatment of late stage esophageal carcinoma.