摘要
背景与目的:伴有吞咽困难症状的食管癌患者置入自膨式食管金属支架(self-expandingesophagealmetalstents,SEMS)后,是否进行放疗或/和化疗等综合治疗,尚存在较大争议,目前缺乏系统的对比研究。本研究拟探讨SEMS联合放、化疗治疗恶性食管狭窄的价值。方法:将283例患者分为单纯置入SEMS组(n=91)和综合治疗组(n=192),对两组的生存时间进行对比,采用Cox回归模型对生存时间的影响因素(包括治疗方式、是否有远处转移和淋巴结转移、有无瘘道形成以及病变部位)进行分析。结果:综合治疗组的生存时间明显长于单纯置入SEMS组,分别为(499.27±239.37)天和(312.81±192.77)天(P<0.0001)。影响生存时间的因素中,治疗方式的相对危险度最大。结论:安置SEMS后联合放疗或/和化疗对延长伴有吞咽困难症状的食管癌患者的生存时间更有效。
BACKGROUND &OBJECTIVE: Owing to the lack of a systematic comparati ve study, it still remains a controversial issue whether a patient with malignan t esophageal tumor causing dysphagia should receive radiotherapy or/and chemothe rapy after the SEMS (self-expanding esophageal metal stents) implantation opera tion. The present paper aims at a careful study of this field. METHODS: A total of 283 specimens were divided into two groups, namely, the group merely receivin g the SEMS implantation operation (Group 1, n=91) and the group receiving a comb ined treatment of the SEMS implantation operation followed by radiotherapy/and chemotherapy (Group 2, n=192). The survival time of the patients in the two diff erent groups was compared and the factors associated with the survival time were analyzed by means of Cox regression method. RESULTS: The survival time of the p atients in group 2 was apparently much longer than that of the patients in group 1 (499.27±239.7 days and 312.81±192.77 days, respectively, P< 0.0001). The fa ctors associated with the survival time included the choice of treatment method, incidence of distant metastasis and lymph node metastasis, formation of esophag eal fistula and the location of diseased area. Among them the relative risk of t reatment method is the highest. CONCLUSION: A combined treatment of SEMS implant ation operation followed by radiotherapy and chemotherapy is significantly assoc iated with the effect of treatment and will undoubtedly prolong the life of the patients with malignant esophageal tumor causing dysphagia.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2004年第6期682-684,共3页
Chinese Journal of Cancer
关键词
食管肿瘤
恶性食管狭窄
金属支架
综合治疗
生存时间
Esophageal tumor
Malignant esophageal stricture
Metal stents
Comb ined Treatment
Survival time
