| Research background and purpose:Esophageal cancer is one of the deadliest malignant tumors in the world,with hidden early symptoms,high late diagnosis rate,lack of effective treatment,low survival rate,and traditional surgical treatment usually does not produce the desired effect in advanced esophageal cancer.Therefore,it is of great significance to explore an effective treatment method to improve the quality and survival rate of patients.The purpose of this study was to compare the clinical efficacy of the three treatments of esophageal stent placement(Bracket placement,BP),stent placement under the combined endoscope radiofrequency ablation(ERFA),and stent placement of radiotherapy/chemotherapy in patients with advanced esophageal cancer,and to analyze the factors that affect their prognosis.Method:Using multi-center retrospective study 105 cases of patients with esophageal cancer who were placed in a metal cladding stent and treated with radio frequency ablation or radiation chemotherapy under the combined endoscope were divided into stent-placed group,stent-placed combined radiation chemotherapy group,stent-placed In three groups of rf frequency ablation group under the combined endoscope,the improvement degree of swallowing difficulty before and after treatment was compared with the incidence of near-term complications,the time of scaffolding after treatment,the medium survival time,the overall survival rate,and the difference of survival of different clinical station groups.Select the following factors that may have an impact on the prognosis of patients with advanced esophageal cancer: sex,age,pathogenesis,distance from the door teeth,intrusion and depth,degree of differentiation,clinical TNM phase,pathological division,radiotherapy and radio frequency ablation therapy,and use Cox regression model to analyze independent factors affecting prognosis.Result::1.The medium survival time of the three groups of bracket-placed group,stent-placed combined radio-chemotherapy group and stent-placed joint RADIO ablation group was 6.7 months(2.9-13.2 months),8.7 months(3.0-17.4 months),and9.2 months(4.0-16.7 months).The difference in mid-life time between the simple bracket-placed group and the bracket-placed joint radiotherapy group has obvious statistical significance(log-rank test,P-0.016);There was no statistically significant difference in the medium survival time of the combined radio frequency ablation group placed in the combined chemotherapy group and the radio frequency ablation group placed in the stent under the combined endoscope(log-rank test,P-0.572).2.The medium bracket flow time of the bracket-placed group,the stent-placed combined chemotherapy group and the bracket-placed radio frequency ablation group was 4.2 months(2.0-6.8 months),8.0 months(3.2-13.2 months),and 6.8 months(4.0-11.5 months),respectively.The difference in the time difference between the medium stent smoothing time in the stent-in group and its combined radiotherapy group was significantly statistically significant(Mann-Whitney U test,P<0.001);There was no statistically significant difference in the time difference between mann-Whitney U test,P<0.001),the time difference between the scaffold placed in the combined chemotherapy group and its combined endoscope radio frequency ablation group(Mann-Whitney U test,P=0.25).3.There were no statistical differences in chest pain,bleeding and reflow of three groups of recent complications of chest pain,bleeding and reflow in three groups of simple stent-placed group,stent-placed combined radiation chemotherapy,and post>operative complications in three groups with statistical differences(P<0.01).4.Multi-COX regression model analysis of differentiation degree,clinical TNM station is a statistically significant independent prognostic factor.Conclusion:1.Simple stent in,radio frequency ablation joint stent in and chemotherapy joint stent in the treatment of advanced esophageal cancer is safe,feasible and effective,can improve the quality of life of patients.2.Radiofrequency ablation combined stenting and radiation and chemotherapy combined stenting is purer stents can prolong patient stent patency and the long-term survival time,although radiofrequency ablation combined stents with radiation and chemotherapy treatment no significant statistical difference,but joint radiofrequency ablation stents is radiation and chemotherapy combined treatment of the median survival time 0.5 months,In the TNM IV stage,the 12-month survival rate of radiofrequency ablation combined with stent was better than that of radiofrequency combined with stent,and the 6-month survival rate of radiofrequency combined with stent was better than that of radiofrequency combined with stent.In conclusion,L’ablation par radiofréquence stent commun en place pour soulager l’obstruction oesophagienne dans les patients présentant le cancer oesophagien de l’étape TNM IV est digne de la promotion et de l’utilisation cliniques.3.The degree of differentiation and clinical TNM stage are the risk factors that affect the survival time of patients with advanced esophageal cancer. |
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