经外周置入中心静脉导管营养支持联合适形调强放疗治疗全梗阻性食管癌的近期疗效观察  

Short-term effect observation of total obstructive esophageal cancer treatment by nutritional support by peripherally inserted central venous catheter and intensity modulated radiation therapy

作　　者：赵辉[1] 朱成斌[1] 章恒[1] 张建庆[1] Zhao Hui;Zhu Chengbin;Zhang Heng;Zhang Jianqing(Radiotherapy Department,People's Hospital of Xinjiang Uygur Autonomous Region,Xinjiang Urumqi 830000,China.)

机构地区：[1]新疆维吾尔自治区人民医院放疗一科

出　　处：《现代肿瘤医学》2020年第2期223-226,共4页Journal of Modern Oncology

基　　金：新疆维吾尔自治区自然科学基金项目(编号:2014211A065);新疆维吾尔自治区人民医院科技引进创新项目(编号:20180209)

摘　　要：目的:探讨经外周植入的中心静脉置管(PICC)营养支持联合三维适形调强放疗治疗完全梗阻性食管癌的近期疗效。方法:研究对象为新疆维吾尔自治区人民医院2010年5月至2017年10月收治的食管鳞状细胞癌并完全梗阻患者36例,均先行1~2周经外周植入的PICC全营养支持治疗,再接受三维适形调强放射治疗,靶区处方剂量为95%PTV 60~66 Gy/30~33 f,2 Gy/f,5次/周。观察患者治疗后的一般情况和临床获益、进食症状改善、梗阻缓解及急性不良反应的发生情况。结果:治疗后,患者一般情况各指标均较治疗前有明显改善(P<0.05);患者的临床获益反应各指标均较治疗前改善(P<0.05),临床获益率为100%;进食症状改善总有效率为83.3%;近期梗阻缓解总有效率为91.7%;放疗急性不良反应主要为轻度的气管反应、白细胞降低、血小板降低和恶心,患者均可耐受。结论:对完全梗阻性食管癌患者积极予以PICC营养支持再加三维适形调强放疗,可提高患者体重,改善进食症状,缓解食管梗阻,且不良反应较轻。Objective:To investigate the short-term efficacy of peripherally implanted central venous catheter(PICC)nutrition plus three-dimensional conformal intensity modulated radiation therapy for completely obstructive esophageal cancer.Methods:36 patients with esophageal squamous cell carcinoma and complete obstruction admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from May 2010 to October 2017 were selected the subjects.All patients received 1~2 weeks of peripherally implanted PICC total nutritional support therapy,followed by three-dimensional conformal intensity modulated radiation therapy.The target prescription dose was 95%PTV 60~66 Gy/30~33 f,2 Gy/f,5 times/week.The general situation,clinical benefit,improvement of eating symptoms,alleviation of obstruction and occurrence of acute adverse reactions were observed. Results: After treatment,the general condition of the patients improved significantly ( P <0.05).The clinical benefit response of patients was improved ( P <0.05).The clinical benefit rate was 100%,and the total effective rate of improving eating symptoms was 83.3%.The total effective rate of recent obstruction relief was 91.7%.The main acute adverse reactions of radiotherapy were mild tracheal reaction,leukopenia,thrombocytopenia and nausea,which were tolerable. Conclusion: Active PICC nutritional support plus three-dimensional conformal intensity modulated radiation therapy for patients with complete obstructive esophageal cancer can improve their physical quality,improve eating symptoms and alleviate esophageal obstruction,with less adverse reactions.

关 键 词：中心静脉置管 营养 放疗 完全梗阻 食管癌 

分 类 号：R735.1[医药卫生—肿瘤]