晚期食管癌支架置入术后放疗和化疗的价值

:510060,:,E2mail:[e-mail]()53,()(KPS)(),KPS;9/271/26,(P=0.007),(24541)d(26243)d,(P=0.813)(),/;/;TreatmentofunresectableesophagealcarcinomabystentingwithorwithoutradiochemotherapyFUJian2hua,RONGTie2hua,LIXiao2dong,YUHui,MAGuo2wei,MINHua2qing.TumorHospital,ZhongshanUniversity,Guangzhou510060,ChinaCorrespondingauthor:FuJian2hua,E2mail:[e-mail]luatethebenefitsofpost2stentingradiotherapyand/orchemotherapyforunresectableesophagealcarcinoma.MethodsFifty2threepatientswithunresectableesophagealcarcinomawererandomlydividedintotwogroups:patientsingroupA(n=27)weretreatedwithstentingalone,andthoseingroupB(n=26)weretreatedwithstentingfollowedbyradiotherapyand/orchemotherapy.Comparisonwasmadebyassessingtheirsurvivaltime,qualityoflife(QOL),degreeofdysphagia,andstenting2relatedmorbidity,respectively.ResultsTherewasnostatisticallysignificantimprovementindysphagiaandQOLbetweenthetwogroups.Althoughtherewasnodifferenceinthefrequencyofstenting2relatedcomplications,re2stenosisoccurredmuchlessfrequentlyingroupBpatients(P=0.007).Themeansurvivaltimeofpatientswas24541daysand26243daysingroupAandgroupB,respectively.Therewasnosignificantdifferencebetweenthetwogroups(P=0.813).ConclusionBesidesdecreasedrecurrenceofstenosis,post2stentingradiotherapyand/orchemotherapydoesnotprovideadditionalbenefitsforsurvival.SubjectwordsEsophagealneoplasms/radiotherapy;Esophagealneoplasms/drugtherapy;Stents,,(),(),1.::(1),;(2)(),;(3);(4)4.0109/L,100.0109/L,;(5)(KPS)5019972001532.::A:,27B:(),26,,,B1,23.:(1)KPS;(2)4.:90120042262ChinJOncol,February2004,Vol26,No.2©1995-2005TsinghuaTongfangOpticalDiscCo.,Ltd.Allrightsreserved.1AB(,€xs)(cm)(cm)3KPS3A27161164.214.061296.942.070.270.11380B2623359.49.6111058.022.510.240.1238032AB/ABA2723222133B26242017455.:Kaplan2Meier,LogrankGianturcoZ(Wilson2Cook)Ultraflex(BostonScientific)()X[1]()1.:13,9,5270Gy,60Gy;326,33,39.5Gy;120Gy2.:65,6066Gy,2:52Fu500mg/m2,1,15;DDP20mg/m2,1,15;341116Gy3.:715:52Fu750mg/m2,1,15;DDP20mg/m2,1,15,CBP300mg/m2,1;34A27,25,1,1;B26,25(5),1AB3,4A15;B2,43ABKPS(%)A04(0)60100(90)15/2755.6B04(0)40100(90)9/2634.6P0.2110.2250.129:()4ABA426313B711020P0.2820.1610.0070.5340.083AB(24541)d(95%CI164325d)(26243)d(95%CI179346d)Kaplan2Meier1,AB(P=0.813)1ABKaplan2MeierBRTOG,13,3;6,1WHO,7,01120042262ChinJOncol,February2004,Vol26,No.2©1995-2005TsinghuaTongfangOpticalDiscCo.,Ltd.Allrightsreserved.,,,Ludwig[2],(P0.05),,[327][8],,[9],,(P0.05),,[10],[11,12],,[13],,AB3,,,,,,24.5%,22%50%[11,14],AB,,()4,A,B,(P=0.813),(),,,,,,(),(),,,2,(),,()62,1,,,..,1999,15:1532156.2LudwigD,DehneA,BurmesterE,etal.Treatmentofunresectablecarcinomaoftheesophagusorthegastroesophagealjunctionbymeshstentswithorwithoutradiochemotherapy.IntJOncol,1998,13:5832588.3,,,..,1999,6:28229.4,,,..,2001,20:1272129.5..,2000,27:3622363.6,,.16.,2000,39:366.7,,,..,1998,15:31.8,,,..,2000,15:3662370.9,,,..,2001,2:44245.10,,,..,2001,10:50.11SiersemaPD,HopWC,vanBlankensteinM,etal.Anewdesignmetalstent(Flamingostent)forpalliationofmalignantdysphagia:aprospectivestudy.GastrointestEndosc,2000,51:1392145.12NicholsonDA,HaycoxA,KayCL,etal.Thecosteffectivenessofmetaloesophagealstentinginmalignantdiseasecomparedwithconventionaltherapy.ClinRadiol,1999,54:2122215.13RaijmanI,SiddiqueI,AjaniJ,etal.Palliationofmalignantdysphagiaandfistulaewithcoatedexpandablemetalstents:experiencewith101patients.GastrointestEndosc,1998,48:1722179.14GolderM,TekkisPP,KennedyC,etal.Chestpainfollowingoesophagealstentingformalignantdysphagia.ClinRadiol,2001,56:2022205.(:2002207211)11120042262ChinJOncol,February2004,Vol26,No.2©1995-2005TsinghuaTongfangOpticalDiscCo.,Ltd.Allrightsreserved.