Kuvshinov Iu P, Poddubnyĭ B K, Aliev V M, Vasygova N F, Efimov O N, Khydyrov Kh B, Saliuk V A
Sov Med. 1990(3):28-31.
The authors analyze the results of endoscopic laser recanalization in 11 patients with stenosing esophageal carcinoma, whose mean age is 61 years. The tumor was located in the upper thoracic portion of the esophagus in 3 patients, in the middle thoracic portion in 6, and in the lower thoracic portion in 2 patients. The diagnosis of carcinoma was morphologically verified. The length of the esophagus involvement was estimated by x-ray data and varied from 5 to 12 cm and longer. Endophytic form predominated--it was diagnosed in 5 patients. The technique of endoscopic laser recanalization by means of Raduga-1 unit with neodymium alumo-yttrium garnet laser as the source of irradiation is described. The method was specified with consideration for the type of tumor growth. The patients were kept on parenteral nutrition during the treatment session. Three-five days after endoscopic laser destruction long-distance open-field gamma-beam therapy was administered to 10 patients and polychemotherapy to 9 of these. After laser destruction dilatation of the stenosed portion of the esophagus from 0.2-0.6 to 1.0-2.0 cm was recorded in 10 patients. Complete regression of the tumor resultant from laser destruction and chemoradiotherapy was achieved in 5 patients, partial regression in the rest 5. The patients were followed up for 5-12 months. No recurrences were recorded in patients with complete regression of the tumor; the process progressed in 3 cases with partial regression. Studies on improvement of recanalization technique, specification of indications for and contraindications against this treatment modality are in progress.
作者分析了11例食管狭窄性癌患者的内镜激光再通术结果,这些患者的平均年龄为61岁。3例患者的肿瘤位于食管胸段上部,6例位于胸段中部,2例位于胸段下部。癌的诊断经形态学证实。根据X线数据估计食管受累长度,范围为5至12厘米及更长。内生型为主——5例患者诊断为此型。描述了使用配有钕铝石榴石激光作为辐射源的“彩虹-1”装置进行内镜激光再通术的技术。该方法根据肿瘤生长类型进行了细化。治疗期间患者接受肠外营养。内镜激光破坏后三至五天,10例患者接受了远距离开放野伽马射线治疗,其中9例还接受了多药化疗。10例患者在激光破坏后,食管狭窄段从0.2 - 0.6厘米扩张至1.0 - 2.0厘米。5例患者经激光破坏及放化疗后肿瘤完全消退,其余5例部分消退。对患者进行了5至12个月的随访。肿瘤完全消退的患者未记录到复发;3例部分消退的患者病情进展。目前正在进行关于改进再通技术、明确该治疗方式的适应证和禁忌证的研究。