经皮全面冷冻治疗手术失败转移性食管癌回顾性分析/Percutaneous comprehensive cryoablation for metastatic esophageal cancer after failure of radical surgery
Liu Shupeng, Yao Fei, Zeng Jianying et al.
【摘要】
目的：对根治性手术失败后的转移性食管癌患者氩氦刀经皮冷冻治疗的疗效进行回顾性分析。
方法：140 例转移性食管癌患者，105 例患者接受氩氦刀经皮冷冻消融治疗，35 例接受化疗。对所有入组患者进行随访，统计患者总体生存期，分析病理类型、治疗方案、治疗时间及治疗次数对患者总体生存期影响。结果冷冻组患者总生存时间显著长于化疗组（冷冻组：39 个月；化疗组：18 个月，P＝0.000 6）。在冷冻组中，鳞癌患者的总生存时间长于腺癌患者总生存时间（P＝0.043 5）；及时治疗患者总生存时间长于延期治疗患者（P＝0.019 3）；多次治疗的患者总生存时间长于单次治疗患者（P＝0.017 2）。
结论：对于根治性手术失败后的转移性食管癌，冷冻治疗相比化疗更具优势，及时多次冷冻治疗效果更为显著。
【关键词】 食管肿瘤； 肿瘤转移； 冷冻疗法； 总生存时间
[Abstract]
Objective This study assessed cryoablation therapeutic effect in metastaticesophageal cancer(MEC) after failure of radical surgery.
Methods One hundred and forty patients wereenrolled in this study. Among these metastatic esophageal cancer patients, 105 patients were carried outcomprehensive cryoablation in multiple metastases and 35 patients received chemotherapy. Overall survival(OS) was assessed and the relationship between OS and therapeutic protocol, pathologic type,treatment timing and number of procedures were investigated. Results The OS of patients who received comprehensive cryoablation was significantly longer than that of those who underwent chemotherapy(39 months vs. 18 months P＝0.000 6). In the cryotherapy group, the OS for squamous cell carcinoma was longer than that for adenocarcinoma(P＝0.043 5); the OS for timely cryoablation was longer than that for delayed cryoablation(P＝0.019 3); the OS for multiple cryoablation was longer than that for single cryoablation(P＝0.017 2).
Conclusion Cryotherapy may have advantages over chemotherapy in the treatment of metastatic MEC, and cryoablation may be associated with a better prognosis in patients with squamous cell carcinoma, timely and multiple treatment.
[Key words] Esophageal neoplasms; Neoplasm metastasis; Cryotherapy; Overall survival
