^(125)Ⅰ放射性粒子食管支架治疗进展期食管癌的生活质量评价  

Implantation of esophageal stent carrying ^(125)Ⅰ radioactive seeds for the treatment of advanced esophageal cancer: evaluation of patient's quality of life

作　　者：赖光湖[1] 窦娟[2] 吴小明[1] 郭敏[1] 胡奎[1] 郎伟思[1] 杨龙[1] LAI Guanghu;DOU Juan;WU Xiaoming;GUO Min;HU Kui;LANG Weisi;YANG Long(Department of Cardiothoracic Surgery,Fifth People＇s Hospital,Chongqing 400062,China)

机构地区：[1]重庆市第五人民医院胸心外科,400062 [2]重庆市第五人民医院老年病学科,400062

出　　处：《介入放射学杂志》2018年第9期842-846,共5页Journal of Interventional Radiology

摘　　要：目的评价^(125)Ⅰ放射性粒子支架治疗进展期食管癌的近期生活质量。方法 2012年8月至2016年12月,应用EORTC-QLQ-C30及EORTC-QLQ-OES18量表评价^(125)Ⅰ放射性粒子支架治疗进展期食管癌24例患者的术前及术后1、4、12和24周生活质量。结果所有患者手术均成功,没有支架移位或无法释放。患者术后总体生活质量、躯体及情绪功能评分增加,在术后1周时,吞咽困难、恶心呕吐方面评分较术前明显降低,术后吞咽困难及恶心呕吐症状明显缓解。术后24周,吞咽困难评分有所增加,4例(4/14,28.5%)出现再狭窄;术后在胸痛及反流症状中的评分比术前增加,术后1周有9例(9/24,37.5%)出现较严重的胸痛。结论 ^(125)Ⅰ放射性粒子食管支架置入术后近期生活质量较术前明显提高,尽管有较多患者反映有较严重的胸痛和反流。Objective To evaluate the short-term quality of life of patients with advanced esophageal cancer receiving implantation of esophageal stent loaded with 125Ⅰ radioactive particles. Methods A total of 24 patients with advanced esophageal cancer, who were treated with implantation of esophageal stent loaded with 125Ⅰ radioactive seeds during the period from August 2012 to December 2016, were enrolled in this study.EORTC-QLQ-C30 and EORTC-QLQ-OES18 scales were used to evaluate the quality of life before treatment as well as at one, 4, 12 and 24 weeks after treatment. Results Successful stent implantation was accomplished in all 24 patients. No stent migration or failure of stent release was observed. After the treatment, the overall quality of life and the physical as well as emotional function were improved, with the scores being increased. One week after the treatment, the scores of dysphagia, nausea and vomiting became significantly lower than preoperative ones, with the symptoms being obviously relieved. Twenty-four weeks after the treatment, the scores of dysphagia showed a certain increase; restenosis of the esophagus occurred in 4 patients（4/14, 28.5%）. The postoperative scores of chest pain and reflux symptoms were higher than preoperative ones. Nine patients（9/24, 37.5%） complained of severe chest pain in one week after the treatment. Conclusion In treating patients with advanced esophageal cancer, implantation of esophageal stent loaded with 125Ⅰ radioactive seeds can effectively and significantly improve the short-term quality of life,although many patients develop severe chest pain and symptoms of esophageal reflux.

关 键 词：食管支架 放射性粒子 生活质量 125Ⅰ粒子 

分 类 号：R735.4[医药卫生—肿瘤]