食管带膜支架捆绑放射性粒子碘-125置入治疗晚期食管癌的临床应用  

Clinical Application of Esophageal Stent with Membrane Bound Radioactive Particles Iodine-125 Implantation for Patients with Advanced Esophageal Cancer

作　　者：梁云 邹秀珍 李宇鸣 

机构地区：[1]阳山县人民医院,广东阳山513100

出　　处：《中外医学研究》2014年第10期128-129,共2页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的：探索放射性^125I粒子支架治疗晚期食管癌的可行性、安全性及初步疗效。方法：选择16例食管癌患者，临床分级均为Ⅲ-Ⅳ级，根据患者病变的大小通过治疗计划系统（treatment plan system，TPS）计算出放射粒子的剂量并准确固定在支架外侧，将支架置入患者食管内观察疗效并进行临床随访。结果：16例患者的内照射支架均释放到位，释放过程顺利，释放过程中未出现125I粒子脱落现象。术后2个月胸部CT复查病变厚度和体积较术前有所缩小12例，无变化2例，增大2例。2例患者分别于术后3、5个月死亡。术后6个月复查胃镜示14例患者未出现食管穿孔、出血等并发症，未出现支架移位，未出现食管再狭窄。结论：食管带膜支架捆绑放射性粒子置入是晚期食管癌癌性狭窄目前一种快速、有效、安全的姑息治疗手段，既能立刻解除了食管梗阻，改善了患者进食状况，又能够减缓了肿瘤生长速度，提高了生活质量。Objective：The purpose of this study was to explore the feasibility,safety and efficacy of the 125I radioactive particles stent in the treatment of advanced esophageal cancer.Method：16 case of esophageal cancer patients diagnosed with clinical staging ofⅢtoⅣwere selected.Treatment planning system （TPS） was employed to calculate the radiation particle dose according to the size of lesion.The radioactive particles were accurately fixed outside the frame of the stents which were implanted in patients with esophageal cancer.To observe the clinical effect and pay a return visit.Result：The stents in 16 patients were released in place and smoothly,and 125I particles did not appear to release during shedding.After 2 months of the cooperation,chest CT examination was conducted for the patients, the results showed that the thickness and volumes of the lesion had reduced in 12 cases,no chang in 2 patients and increased in 2 patients also.After the operation 2 patients died in 3 and 5 months,respectively.6 months after the treatment,14 patients being diagnosed using gastroscopy did not appear esophageal perforation, bleeding,stent migration,or esophageal restenosis complications.Conclusion：The study indicates that esophageal stent with membrane bound radioactive seeds implantation is a quick,effective and conservative therapy in the treatment of advanced esophageal carcinoma stricture.This method could help the patients to relieve their esophageal obstruction immediately,slow down the rate of tumor growth,and ultimately help them to improve life qualities.

关 键 词：食管癌 放射性碘-125粒子 食管支架 

分 类 号：R735.1[医药卫生—肿瘤]