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机构地区:[1]山东省五莲县人民医院肿瘤科,262300 [2]首都医科大学附属北京朝阳医院放疗科 [3]山东省肿瘤医院放疗科山东省医学科学院山东省放射肿瘤学重点实验室
出 处:《国际肿瘤学杂志》2012年第12期932-935,共4页Journal of International Oncology
基 金:国家自然科学基金资助项目(81101699、81172596);山东省自然科学基金资助项目(ZR2011HL059)
摘 要:恶性气管食管瘘(MTEF)是恶性肿瘤累及气管或支气管壁及食管而引起的气管、支气管等呼吸道与食管的病理性交通。MTEF的诊断需要食管造影来确定,瘘口的位置和大小往往需要进一步行支气管镜和食管镜检查来确定。MTEF往往预后不良,治疗措施多以姑息症状和改善生活质量为目的。治疗需要根据患者进行个体化选择,包括食管支架置入术、食管旷置和旁路替代、瘘管切除和修补、放疗等手段,可以延长部分患者的生存期,改善生活质量。MTEF不是化放疗的绝对禁忌证,化放疗尽管可能会合并急性毒性反应,但只要能够成功控制瘘口,可使一般情况好、无远处转移的患者获得较长的生存期。Malignant tracheoesophageal fistula (MTEF) is pathological communication between the respiratory tracts such as the trachea or bronehia and the esophagus because of malignant tumor dissemination through them. Radiography is an important adjunctive technology in the diagnosis of MTEF, and the location and size of fistula often need the further diagnosis of bronchoscopy and esophagoscopy. The patients are often with an unfavourable prognosis once developed MTEF, and are treated usually with the aim of symptom pallia- tion and life quality improvement. The individual treatment includes esophageal stenting, esophageal exclusion and esophagus bypass, fistula exclusion and repair, radiotherapy and others effective therapy according to the patients condition. These therapies will prolong the life span and improve the life quality of patients. MTEF is not absolute contraindieation for chemoradiotherapy. Despite its acute toxicity, this concurrent ehemoradiothe rapy protocol appears feasible and effective at closing esophageal malignant fistula, especially in patients in a good general condition and without metastasis.
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