ABSTRACT
Objective:
To explore the
efficacy and
safety of treating advanced
esophageal cancer by implanting the common
stent and the radioactive 125I particle
stent with
endoscope.
Methods:
The clinical data of
patients with advanced
esophageal cancer admitted to Jingbian County People's
Hospital of Shaanxi Province, the First Affiliated
Hospital of Xi'an Medical
University, Xijing
Hospital of Digestive
Diseases of
Air Force Medical
University and the First
Hospital of Yulin of Shaanxi Province from December 2014 to December 2020 were retrospectively analyzed.
Patients were divided into common
stent group ( n=66) and radioactive particle
stent group ( n=34) according to different
stent types. The
postoperative complications,
Karnofsky performance status (KPS) score,
dysphagia score, restenosis rate and
quality of life were compared between the two groups.
Results:
The
incidences of postoperative retrosternal
pain in the common
stent group and the radioactive particle
stent group were 65.2% (43/66) and 47.1% (16/34) respectively. The
incidences of pharyngeal
pain and
hoarseness were 12.1% (8/66) and 5.9% (2/34) . The
incidences of
abdominal pain were 9.1% (6/66) and 2.9% (1/34) . The
incidences of errhysis were 3.0% (2/66) and 2.9% (1/34) . The
incidences of
vomiting and
nausea were 7.6% (5/66) and 5.9% (2/34) respectively. There were no statistically significant differences between the two groups ( χ2=3.04, P=0.081; χ2=0.40, P=0.527; χ2=0.53, P=0.467; χ2<0.01, P>0.999; χ2<0.01, P>0.999) . In the two groups, KPS scores in the first, second, third and sixth month after operation were higher than those before operation (all P<0.05) . KPS scores of the radioactive particle
stent group in the second, third and sixth month were significantly higher than those of the common
stent group [ (89.73±7.84) points vs. (82.37±7.42) points, t=4.62, P<0.001; (93.63±8.13) points vs. (88.33±7.28) points, t=3.74, P<0.001; (92.78±6.26) points vs. (87.28±8.73) points, t=3.77, P<0.001]. The
dysphagia scores of
patients in the two groups in the first, second, third and sixth month were lower than those before operation (all P<0.05) . The
dysphagia scores of the radioactive particle
stent group in the third and sixth month after operation were significantly lower than those of the common
stent group [ (0.68±0.12) points vs. (2.33±0.32) points, t=26.20, P<0.001; (0.82±0.22) points vs. (2.67±0.24) points, t=36.92, P<0.001]. In the third month after operation, the restenosis rate of the radioactive particle
stent group was significantly lower than that of the common
stent group [5.88% (2/34) vs. 42.4% (28/66) , χ2 =14.27, P<0.001]. The scores of QLQ-C30 and OES-18
scales in the first, second, third and sixth month after operation were lower than those before operation (all P<0.05) . The scores of QLQ-30 scale in the radioactive particle
stent group in the second, third and sixth month were significantly lower than those in the common
stent group [ (19.12±3.02) points vs. (21.22±2.87) points, t=3.39, P=0.001; (15.04±1.68) points vs. (20.43±2.23) points, t=12.39, P<0.001; (14.38±2.18) points vs. (19.77±3.67) points, t=9.20, P<0.001]. The scores of OES-18 scale in the radioactive particle
stent group were also significantly lower than those in the common
stent group [ (17.13±2.07) points vs. (20.64±2.11) points, t=7.95, P<0.001; (15.22±1.88) points vs. (19.24±1.76) points, t=10.62, P<0.001; (14.74±2.36) points vs. (18.53±3.27) points, t=6.01, P<0.001].
Conclusion:
The radioactive particle
stent can improve the
quality of life of
patients with advanced
esophageal cancer with
esophageal stenosis, so as to improve
dysphagia and reduce the restenosis rate after operation. However, whether it is obviously superior to common
stent in prolonging
survival time and reducing
complications needs to be further confirmed by a multicenter, prospective, large-sample randomized controlled study.