Renwick P, Whitton V, Moghissi K
Humberside Cardiothoracic Surgical Centre, Castle Hill Hospital, Hull.
Gut. 1992 Apr;33(4):435-8. doi: 10.1136/gut.33.4.435.
Palliative treatment for oesophageal malignancy aims to maximise symptom relief with minimal disturbance to the patient. Twenty one patients with oesophageal carcinoma were studied prospectively to assess the combined efficacy of laser and brachytherapy in the palliation of oesophageal carcinoma, 20 were unsuitable for resectional surgery because of tumour extent and one patient underwent the treatment protocol after myocardial infarction, for symptom relief before resection. Two patients died at hospital and the remaining 19 survived from 9 to 455 days (mean 140 days). All patients tolerated the procedure well and improvement in swallowing was noted in 19 who survived the procedure--an improvement that was maintained until their death. However, five patients required oesophageal dilatation after the initial treatment. Results were not affected by the histology of the tumour. In summary, combined endoscopic laser and brachytherapy is effective palliation for oesophageal carcinoma and may be particularly appropriate in those patients with cervical and upper thoracic tumours in whom intubation may be unsatisfactory.
食管癌的姑息治疗旨在最大程度缓解症状，同时对患者的干扰最小。对21例食管癌患者进行了前瞻性研究，以评估激光和近距离放射治疗联合用于食管癌姑息治疗的疗效。20例患者因肿瘤范围而不适合进行切除手术，1例患者在心肌梗死后接受了该治疗方案，以便在切除术前缓解症状。2例患者在医院死亡，其余19例存活9至455天（平均140天）。所有患者对该操作耐受性良好，19例存活患者吞咽功能得到改善，且这种改善一直维持到死亡。然而，5例患者在初始治疗后需要进行食管扩张。结果不受肿瘤组织学的影响。总之，内镜激光和近距离放射治疗联合应用对食管癌是有效的姑息治疗方法，对于那些插管可能不理想的颈段和上胸段肿瘤患者可能尤为适用。
