CAJ | 학술논문

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。
목적：탐색방사성125I입자지가치료만기식관암적가행성、안전성급초보료효。방법：선택16례식관암환자，림상분급균위Ⅲ~Ⅳ급，근거환자병변적대소통과치료계화계통(treatment plan system，TPS)계산출방사입자적제량병준학고정재지가외측，장지가치입환자식관내관찰료효병진행림상수방。결과：16례환자적내조사지가균석방도위，석방과정순리，석방과정중미출현125I입자탈락현상。술후2개월흉부CT복사병변후도화체적교술전유소축소12례，무변화2례，증대2례。2례환자분별우술후3、5개월사망。술후6개월복사위경시14례환자미출현식관천공、출혈등병발증，미출현지가이위，미출현식관재협착。결론：식관대막지가곤방방사성입자치입시만기식관암암성협착목전일충쾌속、유효、안전적고식치료수단，기능립각해제료식관경조，개선료환자진식상황，우능구감완료종류생장속도，제고료생활질량。
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.