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目的 :评价食管镍钛合金支架置入术联合放射治疗晚期食管癌的临床可行性和疗效。方法 :对 88例晚期食管癌并穿孔、瘘、狭窄病人分别行镍钛合金带膜支架置入术和支架联合放射治疗 ,比较单纯支架治疗和联合放射治疗病人的生存率和疗效 ;观察JMZ型镍钛合金支架对放射治疗射线分布的影响。结果 :① 6、9、12个月的生存率联合放射治疗组病人分别为 77.3 %、52 .3 %、3 1.8% ,单纯支架组分别为 79.5%、50 .0 %、13 .6% ,两组比较无统计学意义 (P >0 .0 5) ,但合并症联合放疗组高于单纯支架组 ;②食管癌伴狭窄病人 12、2 4个月生存率联合放疗组分别为 73 .6%、3 6.8% ,单纯支架组分别为 3 0 %、0 ,两组比较有显著差异性 (χ2 =18.9841,P =0 .0 0 0 1) ;③JMZ型镍钛合金支架对食管癌放射治疗剂量分布影响在± 2 %左右。结论 :晚期食管癌合并穿孔、瘘病人支架置入术联合放射治疗不能提高生存率 ,而且增加合并症 ;支架置入术联合放射治疗可应用于合并食管狭窄的病人 ,提高一、二年生存率 ,值得临床进一步研究 ;JMZ型镍钛合金支架对食管放疗剂量无明显影响
Objective: To evaluate the clinical feasibility and efficacy of esophageal nitinol stenting combined with radiotherapy for advanced esophageal cancer. Methods: Eighty-eight advanced esophageal cancer patients with perforation, fistula and stenosis were treated with nitinol stent implantation and stent combined radiotherapy. The survival rate and curative effect of simple stent and combined radiotherapy were compared. Effect of NiTi stent on the radiation distribution of radiation therapy. Results: The survival rates of 6, 9 and 12 months were 77.3%, 52.3% and 3.8% in the radiotherapy group, 79.5%, 50.0% and 13.6% in the stent group alone, There was no significant difference between the two groups (P> 0.05), but the combined radiotherapy group was higher than the simple stent group; (2) The survival rate of 12,24 months in patients with esophageal cancer with stenosis was 73.6 %, 6.8% in the simple scaffold group and 30% in the simple scaffold group, respectively. There was significant difference between the two groups (χ2 = 18.9841, P = 0.0001) Dose distribution affects ± 2%. Conclusion: The treatment of advanced esophageal cancer combined with perforation and fistula stenting combined with radiotherapy can not improve the survival rate, but also increase the complication. Stent implantation combined with radiotherapy can be applied to patients with esophageal stenosis and improve the one-year and two-year survival rate , Worth further clinical study; JMZ-type nitinol stents on esophageal radiation dose had no significant effect