靶动脉灌注维拉帕米对晚期食管癌介入疗效的临床观察

目的观察靶动脉灌注维拉帕米联合化疗药物对晚期食管癌介入治疗的临床效果。方法 24例晚期食管癌患者,用seldinger穿刺技术经靶动脉灌注维拉帕米联合化疗药物,每个月介入治疗1次,每例介入治疗1～2次,判断其近期临床疗效。结果 24例晚期食管癌癌患者中23例获得部分缓解（PR）,1例无变化（NC）,有效率（CR＋PR）为95.80%（23/24）;所有24例患者治疗后吞咽困难症状较治疗前均有不同程度好转;4例患者治疗前伴有喉返神经麻痹导致的声音嘶哑症状,治疗后声嘶症状均完全缓解;11例患者KPS评分、营养状况及体质量均临床获益;治疗后主要毒副反应表现：其中出现白细胞下降6例（25.00%）、恶心、呕吐15例（62.50%）、腹泻3例（12.50%）、脱发1例（4.17%）、发热1例（4.17%）、肝功能损害3例（12.50%）等,均主要为I～Ⅱ度反应;以上不良反应均在短时间内缓解;所有患者行维拉帕米灌注治疗前、中、后均未见心率、血压、心功能的明显变化,也无相关不适临床表现。结论晚期食管癌患者经靶动脉灌注维拉帕米联合化疗药物可提高化疗药物的疗效,同时改善患者的并发症,明显提高晚期食管癌患者的生存质量,近期临床疗效显著。

Clinical evaluation of targeted arterial infusion of verapamil in the interventional chemotherapy for advanced esophageal cancer

Objective To observe the clinical effectiveness of the target artery infusion of verapamil combined with chemotherapy for advanced esophageal cancer. Methods In 24 patients with advanced esophageal cancer,verapamil and chemotherapeutic agents were infused into the target tumor vasculature through femoral artery using seldinger technique.The patients were treated once a month,each case involved treatment of one or two times,then the therapeutic effects were evaluated.Results 23 patients had received partial response(PR),with the effective rate(CR+PR)as 95.8%(23/24);only one patients have received no change(NC);In 11 patients,KPS score/nutritional status/weight were clinical benefit;The major side effects as follow: 6 cases with leukopenia(25%),15 cases with nausea/vomiting(62.5%),diarrhea in 3 case(12.5%),alopecia in 1 patients(4.17%),fever in 1 case(4.17%),liver dysfunction in 3 patients(12.5%);there were no significant changes of heart rate/blood pressure/heart function before or during or after of verapamil infusion.Conclusion The target artery infusion of verapamil combined with chemotherapy can improve the efficacy of chemotherapy in patients with advanced esophageal cancer with less side effects.