肿瘤及放化疗对食管动力的影响。

Effect of tumour and chemoradiotherapy on oesophageal motility.

作者信息

Tormey S, Nasyr A, McNamara D A, Byrne P J, Walsh T N

机构信息

RCSI Department of Surgery, James Connolly Memorial Hospital, Blanchardstown, Dublin, Ireland.

出版信息

Ir J Med Sci. 2003 Jan-Mar;172(1):9-12. doi: 10.1007/BF02914777.

DOI:10.1007/BF02914777

PMID:12760455

Abstract

BACKGROUND

The contribution of dysmotility to dysphagia in oesophageal cancer is unclear.

AIM

To examine oesophageal motility in patients with oesophageal carcinoma and to assess the effect of chemoradiotherapy on motility.

METHODS

Stationary manometry and 24-hour pH-metry were performed in 12 patients with oesophageal carcinoma and one week following completion of chemoradiotherapy using 5-fluorouracil (5-FU), cisplatin and 40Gy radiotherapy.

RESULTS

All patients had abnormal motility prior to treatment. Peristalsis was impaired in 11 patients with a mean (SD) of 25% (9) of waves normally propagated. Eight patients had 20% or more simultaneous waves. Following chemoradiotherapy, the percentage of waves normally propagated increased from 25% (9) to 521% (10) (p < 0.03) and normal peristalsis was restored in four patients. The percentage of simultaneous waves decreased from 38% (11) to 21.6% (10) (p = 0.129) while the percentage of dropped or increased waves decreased from 20% (11) to 8.3% (4) (p = 0.264).

CONCLUSIONS

Oesophageal motility is disturbed in oesophageal cancer. Dysphagia in oesophageal cancer may be partly explained by oesophageal dysmotility. This is improved by chemotherapy.

摘要

背景

动力障碍在食管癌吞咽困难中的作用尚不清楚。

目的

研究食管癌患者的食管动力，并评估放化疗对动力的影响。

方法

对12例食管癌患者在使用5-氟尿嘧啶（5-FU）、顺铂及40Gy放疗进行放化疗前及放化疗结束1周后进行静态测压和24小时pH值监测。

结果

所有患者治疗前均存在动力异常。11例患者蠕动受损，正常传导波的平均（标准差）为25%（9）。8例患者有20%或更多的同步波。放化疗后，正常传导波的百分比从25%（9）增至521%（10）（p<0.03），4例患者恢复正常蠕动。同步波的百分比从38%（11）降至21.6%（10）（p=0.129），而掉落或增加波的百分比从20%（11）降至8.3%（4）（p=0.264）。