^(125)I粒子不同排布方式捆绑于支架治疗晚期食管癌  

Different Implantation Way of ^(125)I Seeds Stent in the Treatment of Unresectable Esophageal Cancer.

作　　者：王浩[1] 

机构地区：[1]杭州师范大学临床医学院(附属医院)/杭州市第二医院心胸外科,310015

出　　处：《医学研究杂志》2008年第1期31-34,129,130,共6页Journal of Medical Research

摘　　要：目的通过观察两组不同分布的125I粒子捆绑支架治疗晚期食管癌的临床疗效,探讨影响疗效的相关因素。方法15例晚期食管癌患者在X线透视下随机分别置入每层3粒,每层相隔1cm(A组n=8)和每层4粒,每层相隔2cm(B组n=7),活度均为0.9mGy/粒的125I粒子捆绑食管支架,对治疗效果及其主要并发症进行观察与随访。结果15例患者均能直接将捆绑支架准确放置到位,近期无死亡,吞咽功能改善为0级13例,1级2例;2个月后CT复查两组食管肿瘤厚度变薄,与术后当天比较均有显著差异(P<0.01),两组间比较无差异(P>0.05)。近期刺激性咳嗽伴咳痰、胸痛和伴有食管炎症状的发生率两组间比较无差异(P>0.05)。远期有良性狭窄A、B组各2例、B组有恶性再狭窄2例,再次置入放射支架。生存期A组为(10.8±3.56)个月(6~20个月),B组为9.6±3.14个月(6~19个月),两组间比较无差异(P>0.05)。结论125I粒子捆绑支架治疗晚期食管癌能明显减轻食管癌的瘤负荷,痛苦小,安全,提高生存率,每层相隔1cm排布的粒子支架能减少恶性再狭窄的发生率。Objective To evaluate the effectiveness and safety of two different implantation ways of 125^Ⅰ seeds stent in the treatment of unresectable esophageal cancer. Methods Fifteen patients were randomly allocated into two groups. In the patient of group A 125^Ⅰ seeds were implanted layer by layer with three seeds in each layer and with a distance of 1 cm between the layers. In group B there are four seeds in each layer and the distance between layers is 2cm. After installation of stent comparison of clinical efficiency and complications between two groups were done. Results Successful stent installation was achieved in 100% and no patient died in a short time after installation. Dysphagia score decreased to 0 grade for thirteen patients and to 1 grade for the others. After two months the thickness of esophageal cancer for both groups of patients decreased significantly（ P 〈 0.01 ） with no statistical significance（ P 〉 0.05 ） between two groups. The duration of chest pain and esophagitis in two groups was no statistical significance（ P 〉 0.05 ）. In group B 2 cases having malignant esophageal obstruction appear , The mean survival time in group A is （ 10.8±3.56） months, （9.6 ± 3.14） months（ P 〉 0.05 ） in group B. Conclusions The method of intraluminal irradiation 125^Ⅰ seeds stent in the treatment of unresectable esophageal cancer is effective. No significant difference was found between two implantation ways of 125^Ⅰ seeds. Implantation with a distance of 1 cm between the layers of 125^Ⅰ seeds stent was more helpful to decreased relapes of malignant esophageal obstruction.

关 键 词：食管癌 支架 125^Ⅰ粒子 组织间放疗 

分 类 号：R735.1[医药卫生—肿瘤] R122.12[医药卫生—临床医学]