经导管动脉灌注化疗治疗溃疡型和伴溃疡髓质型食管癌  

Ulcerative esophageal carcinoma: treatment with transcatheter arterial chemoinfusion

作　　者：宋太民[1] 

机构地区：[1]河南省漯河市中心医院介入放射科,河南漯河462000

出　　处：《中国介入影像与治疗学》2005年第2期117-120,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：河南省医药卫生重点科研课题项目(97 183)。

摘　　要：　目的　探讨经导管动脉灌注化疗(TAI)治疗溃疡型和伴溃疡髓质型食管癌的疗效。方法　对 67 例经食管 X线钡餐造影及病理检查证实(均为鳞癌)的溃疡型(46例)和伴溃疡之髓质型(21 例)食管癌患者,行相应食管段肿瘤供血靶动脉选择性插管造影,并灌注化疗药物。结果　67 例 TAI治疗后近期临床疗效总有效率(完全缓解+部分缓解)为89.54%。治疗后62例(92.54%)恶性溃疡完全消失,5 例(7.46%)部分消失。5 例已形成食管穿孔患者,经治疗均见瘘口闭合,管壁修复。有DSA复查资料的54例中, 23例(42.59%)肿瘤血管和肿瘤染色显示完全消失,31 例(57.41%)显示不同程度减少。11例治疗后手术切除患者,4 例切除标本病检未见存活肿瘤,7 例癌巢有不同程度变性坏死。结论　TAI治疗溃疡型和伴溃疡形成髓质型食管癌效果满意,可作为一种姑息治疗方法。Objective To investigate the efficacy of transcatheter arterial chemoinfusion (TAI) for ulcerative esophageal carcinoma. Methods Sixty-seven cases of histologically verified squamous carcinoma with ulceration were treated with multiple sessions of selective TAI of anticancer agents. Results The overall short-term response (CR+PR) of TAI was 89.54%, in which the malignant ulcers in 62 cases (92.54%) completely and 5 cases (7.46%) partly disappeared. Fistulas in 5 cases of esophageal perforation were found being closed and esophageal walls recovered. Angiographic follow-up of 54 cases showed that tumor vessel and tumor stain faded with different degree in 31 cases (57.41%), while entirely vanished in 23 cases (42.59%). Tumors of 11 cases were surgically resected after TAI. Live tumor tissue were not found in 4 specimens by pathology, and the other 7 were proved to be partly necrotized with different degree. Conclusion TAI of anticancer agents for ulcerative esophageal carcinoma is effective, and long-term follow-up is needed.

关 键 词：髓质型 溃疡型 食管癌 化疗治疗 经导管动脉灌注化疗 选择性插管造影 X线钡餐造影 近期临床疗效 完全消失 不同程度 治疗后 病理检查 肿瘤供血 化疗药物 完全缓解 总有效率 恶性溃疡 食管穿孔 肿瘤染色 肿瘤血管 手术切除 

分 类 号：R735.1[医药卫生—肿瘤] R735.204[医药卫生—临床医学]