选择性动脉插管灌注化学药物治疗中晚期食管癌

目的　探讨中晚期食管癌动脉灌注化疗的疗效、影响疗效的因素和并发症。方法　本组 10 4例 ,男 5 6例 ,女 48例 ,年龄 3 9～ 82岁 ,平均 5 2岁。均经食管吞钡X线片及食管细胞学或病理组织学检查证实为鳞癌患者。全部病例均采用Seldinger技术行相应食管节段的供血靶动脉选择性插管和造影 ,并经导管灌注化疗药物。结果　 10 4例食管癌近期临床疗效总有效率 (完全缓解 +部分缓解 )为 81 7%。 1、2、3年生存率分别为 87 5 % ( 91/ 10 4)、3 9 4% ( 41/ 10 4)和 2 0 2 % ( 2 1/ 10 4)。本组结果提示多次治疗疗效 ( 90 % )优于单次治疗 ( 64 7% ) ( χ2 =8 18,P <0 .0 1) ,多血管型肿瘤疗效 ( 87 8% )优于少血管型 ( 66 7% ) ( χ2 =5 .0 7,P <0 .0 5 ) ,不同类型食管癌疗效也有差别。本组严重并发症有食管穿孔 2例 (其中 1例发生食管大出血 )、坏死性食管炎 2例。结论　食管癌动脉灌注化疗疗效显著 ,副作用小 ,可作为食管癌综合治疗的重要方法。但应注意预防和避免严重并发症的发生

Selective transarterial chemotherapy in the treatment of advanced esophageal cancer

Objective To evaluate the efficacy and complications of selective transarterial chemotherapy in the treatment of advanced esophageal cancer. Methods 104 patients with histologically verified esophageal cancer, 56 males and 48 females with the age ranging from 39 to 82 years, were treated with selective transcatheter arterial infusion chemotherapy.Results The overall response rate (CR+PR)of the therapy was 81.7%, and the 1,2, and 3 years survival rate reached 87.5%(91/104),39.4%(41/104),and 20.2%(21/104),respectively.The effect of multiple infusion excelled that of single treatment,and also the better results occurred in patients with hypervascular tumor compared with hypovascular tumor. There were obvious differences in the response rate to the therapy among various types of esophageal cancer. Some severe complications such as massive haemorrhage, necrosis, and perforation of esophagus were noted. Conclusion Transarterial chemotherapy for patients with esophageal cancer is effective and reliable.It should be regarded as an important part of multidisciplinary therapy for esophageal cancer.However, special attention must be paid to prevent some serious complications.