内镜超声引导下碘125粒子植入术治疗晚期食管癌患者吞咽困难初探

Endoscopic ultrasound-guided iodine-125 seed implantation for treatment of dysphagia in patients with advanced esophageal cancer: a primary study

摘要:

目的 评价内镜超声引导下碘125粒子植入术治疗晚期食管癌患者吞咽困难的安全性及有效性。方法 2017年12月—2018年11月，因晚期食管癌吞咽困难于解放军总医院接受内镜超声引导下碘125粒子植入术治疗的4例病例纳入回顾性分析，主要评价指标为治疗完成情况、并发症发生情况、治疗前后吞咽困难分级情况及内镜下癌灶大小变化情况、随访结果。结果 4例患者均成功完成内镜超声引导下碘125粒子植入术，未出现出血、胸痛、发热、咳嗽等并发症。治疗前吞咽困难分级Ⅱ～Ⅳ级，治疗后3个月降低至0～Ⅰ级，内镜下均可见癌灶有所缩小。随访12～23个月，3例生存，1例肿瘤晚期死亡。结论 内镜超声引导下碘125粒子植入术治疗晚期食管癌吞咽困难是一种安全有效的姑息治疗方法。

Abstract:

Objective To evaluate the safety and efficacy of endoscopic ultrasound (EUS)-guided iodine-125 seed implantation to treat dysphagia in patients with advanced esophageal cancer. Methods Data of 4 patients with dysphagia of advanced esophageal cancer who received EUS-guided iodine-125 seed implantation in Chinese PLA General Hospital between December 2017 and November 2018 were collected in the retrospective study. The evaluation contents included technical success rate of seed implantation, complication, dysphagia grade, tumor size and other follow-up results. Results Four patients successfully completed EUS-guided iodine-125 seed implantation. No haemorrhage, chest pain, fever, cough or other postoperative complications were reported. Three months after treatment, dysphagia grade reduced from Ⅱ-Ⅳ to 0-Ⅰ, and the tumor size in all patients showed a decrease. After 12-23 months of follow-up, 3 patients were alive, and 1 died due to advance of the cancer. Conclusion EUS-guided iodine-125 seed implantation is a safe and effective palliative treatment method for dysphagia in patients with advanced esophageal cancer.