DSA引导下125I粒子覆膜食道支架联合TP方案化疗治疗晚期食管癌  

Clinical observation of radioactive 125Iparticle stent implantation combined with TP chemotherapy under DSA guidance in treatment of patients with advanced esophageal carcinoma

作　　者：张力苹 张启周 栗国梁 陈健英 赵媛媛 刘喜娟 余锡贺 ZHANG Li-ping(Guangdong Province Hospital of combination of traditional Chinese and Western Medicine,Foshan 528200,China)

机构地区：[1]广东省中西医结合医院肿瘤内科,广东佛山528200

出　　处：《牡丹江医学院学报》2020年第1期98-101,108,共5页Journal of Mudanjiang Medical University

基　　金：佛山市医学类科技攻关项目(2018AB000102)。

摘　　要：目的本研究旨在探讨125I粒子覆膜食道支架植入联合TP方案(紫杉醇脂质体联合奈达铂)化疗治疗晚期食管癌患者的有效性及安全性。方法收集2016年1月份至2018年12月间我科收治的48例晚期食道癌患者,其中43例患者可评价,治疗组23例,对照组20例,所有患者进行125I粒子覆膜食道支架治疗,治疗组患者术后2周内接受紫杉醇脂质体联合奈达铂化疗,观察两组患者的短期疗效、不良反应。结果治疗组23例患者共置入125I粒子覆膜金属支架24枚;对照组20例患者共置入125I粒子覆膜金属支架20枚,支架置入术后所有患者吞咽困难程度均得到改善。治疗2月后进行疗效评估,治疗组与对照组的客观缓解率分别为47.83%、15%,两组比较有显著性差异(P<0.05);疾病控制率分别为78.26%、55%,两组比较有显著性差异(P<0.05)。两组患者术后胸痛、咽痛、呕血、呕吐发生率无统计学差异,无围手术期死亡;治疗组患者化疗期间的不良反应可控。结论放射性125I粒子覆膜支架置入联合TP方案化疗治疗晚期食管癌,可迅速改善吞咽困难等症状,短期疗效确切,不良反应可控,值得临床进一步推广。Objective To evaluate the efficacy and safety of the radioactive 125I particle stent implantation combined with TP chemotherapy(Liposomal Paclitaxel and Nedaplatin)under DSA guidance in treatment of patients with advanced esophageal carcinoma.Methods A total of 48 patientswithadvanced esophageal carcinoma were treated with radioactive 125Iparticle stent implantationadmitted from January 2016 to December 2018 in our department,only 43 patients could be evaluated,we observe its efficacy and side effects.Among them,23 patients received the chemotherapy with Liposomal Paclitaxel and Nedaplatin(treatment group),20 patients received the treatment of the radioactive 125Iparticle stent implantation alone(control group).Results 24 radioactive 125I particle stentswere implanted for 23 patientsin the treatment group,20 radioactive 125I particle stentswereimplanted for 20 patientsin the control group,the degree of dysphagia of patients after stent implantation was all improved.After the above treatment,the efficacywas evaluated.The ORR of the treatment group and the control group were 47.83%and 15%,there was significant difference between the two groups(P<0.05).The DCR of the two groups were 78.26%and 55%.The incidence of side effects postoperative such as chest pain,pharyngalgia,a small amount of bleeding in the tumor site,vomiting,were no significant differences between the two groups(P>0.05).No patients died in the perioperative period;there were no severe side reactions during chemotherapy.Conclusion The treatmentof radioactive 125I particle stent implantation combined with TP chemotherapy in patients with advanced esophageal carcinoma can acquire rapid improvement of dysphagia and other symptoms,its short-term effect was definite,and its side effects are acceptable,so it should be generalized in clinic.

关 键 词：食管癌 125I粒子 食道支架 紫杉醇脂质体 奈达铂. 

分 类 号：R735.1[医药卫生—肿瘤] R730.55[医药卫生—临床医学]