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[目的]研究内镜下植入缓释化疗粒子在中晚期食管癌姑息治疗中的临床价值。[方法]将106例中晚期食管癌患者随机分成研究组(IC组,55例)和对照组(SI组,51例)。研究组行内镜粒子植入化疗(IC),对照组行内镜支架置入治疗(SI)。2组患者均在术后定期记载吞咽困难解除程度、有无不良反应与并发症,复查内镜观察肿瘤变化,随访存活时间。根据吞咽困难程度和WHO实体肿瘤按期评价标准作本研究疗效判定标准。[结果]IC组术后早期有效率较SI组低,以后逐渐增高,SI组则逐渐降低,8周后2组疗效比较差异有统计学意义(P<0.01~0.05);胸痛、纵隔脓肿、食管气管瘘等并发症发生率IC组明显低于SI组(P<0.05);IC组死亡20例,平均存活912.5d;SI组死亡32例,平均存活518.5d,生存期IC组较SI组显著延长。[结论]IC突出了局部靶向治疗,具有微创、安全、显著减轻吞咽困难、延长生存期、并发症少等特点,是姑息治疗中晚期食管癌新的有效方法。
[Objective] To study the clinical value of endoscopic implantation of sustained release chemotherapy particles in palliative treatment of advanced esophageal cancer. [Methods] 106 patients with advanced esophageal cancer were randomly divided into study group (IC group, 55 cases) and control group (SI group, 51 cases). The study group underwent endoscopic particle implantation chemotherapy (IC) and the control group underwent endoscopic stent placement (SI). The patients in both groups were regularly recorded after operation to relieve the degree of dysphagia, with or without adverse reactions and complications. The changes of tumor were observed by endoscopy and the survival time was followed up. According to the extent of dysphagia and WHO solid tumor on schedule evaluation criteria for the efficacy of this study to determine the standard. [Results] The effective rate of early operation in IC group was lower than that in SI group, then increased gradually in SI group, and gradually decreased in SI group. After 8 weeks, there was significant difference between two groups (P <0.01 ~ 0.05); chest pain, mediastinal abscess, The incidence of complications such as esophageal tracheal fistula in IC group was significantly lower than that in SI group (P <0.05); in IC group, 20 cases died, the average survival was 912.5 days; in SI group, 32 cases died, the average survival was 518.5 days, Significantly longer. [Conclusion] IC is a new and effective method for palliative treatment of advanced esophageal cancer, highlighting the local targeted therapy, with the characteristics of minimally invasive, safe, significant reduction of dysphagia, prolongation of survival and few complications.