携带125I粒子支架与普通支架治疗中晚期食管癌的临床对照研究

摘要

Objective To assess the clinical value of the implantation of 125I seed-loading stent in treating middle-late stage esophageal cancer.Methods A total of 64 patients with middle-late stage esophageal cancer,who were treated with esophageal stent implantation during the period from July 2013 to December 2015,were included in this study.According to patient's own will,the patients were divided into group A (n=28,using conventional stent) and group B (n=36,using 125I seed stent).Based on the treatment planning system (TPS) and tumor morphology,conformal comprehensive isodose distribution of 125I seeds was formulated.The success rate of stent implantation,the complication rate,the improvement rate of dysphagia,the stent patency rate,the average hospitalization days,the hospitalization expenses and the survival time were compared between the two groups.Results In both groups,the success rate of stent implantation and the improvement rate of dysphagia were all 100％.The 12-month stent patency rate of group B was evidently higher than that of group A,and the difference was statistically significant (P＜0.05).No statistically significant difference in the average hospitalization days existed between the two groups (P＞O.05).The mean hospitalization expenses between the two groups was statistically significant (P＜0.05),with the mean medical expense in group B being 13,769.57 RMB more than that in group A.Both the mean survival time and the median survival time of group B were longer than those of group A (P＜0.05).Conclusion It is safe and effective to use 125I seed stent to treat middle-late stage esophageal cancer.This technique can evidently prolong the survival time of patients,although its medical cost is higher than that of the ordinary stent.%目的 评价携带125I粒子支架治疗中晚期食管癌的临床价值.方法 2013年7月至2015年12月应用食管支架治疗中晚期食管癌64例,根据是否自愿接受125I粒子支架分为两组:普通支架组(A组)28例,125I粒子支架组(B组)36例.125I粒子根据治疗计划系统(TPS)和肿瘤形态适形综合布源.比较两组支架置入成功率、并发症发生率、吞咽困难改善率、支架通畅率、平均住院时间、住院费用及生存期.结果 两组支架置入成功率及短期吞咽困难缓解率均为100％;12个月内B组患者食管支架通畅率明显高于A组,差异具有统计学意义(P＜0.05);平均住院时间两组差异无统计学意义(P＞0.05),平均住院费用两组有显著性差异(P＜0.05),B组比A组平均高约13 769.57元;平均生存期和中位生存期B组均明显长于A组,差异有统计学意义(P＜0.05).结论 125I粒子支架治疗中晚期食管癌安全有效,能明显延长患者生存期,但费用较普通支架高.