Integrated gastrointestinal nutritional tube loaded with double 125I strands for brachytherapy of esophageal carcinoma with degree dysphagia / 中国介入影像与治疗学

ABSTRACT

Objective: To observe the effect of integrated gastrointestinal nutritional tube loaded with double 125I strands applied in esophageal cancer with grade dysphagia. Methods: Interventional catheter technology was used to open the occlusive segment of esophagus in 10 patients with esophageal cancer and grade dysphagia. Then the new integrated tube was fed along the guide wire with 125I segment needs crossing the esophageal occlusion segment for brachytherapy. The technical success rate and clinical success rate were counted. The dosimetry parameters were recorded and compared before and 3 days after operation, while the therapeutic effect were estimated according to Karnofsky score and Neuhaus dysphagia grading 2 months after operation. The patients were followed up for 6 months to observe the prognosis. Results: All 10 patients underwent successful tube insertion. The technical success rate was 100%, and the clinical success rate was 70%. No serious complication occurred. There was no statistically significant difference of 90% of gross tumor volume (GTV) received dose (D90%), GTV minimum peripheral dose (mPD), GTV received 200% and 100% of the prescribed dose volume percentage (V200%, V100%), conformal index (CI) nor external index (EI) before and after operation (all P>0.05). Karnofsky score and Neuhaus grading were significantly improved 2 months after operation (both P<0.01), and the local tumor control rate was 70%. During 6 months' follow-up, dysphagia reoccurred in 1 case, 2 cases died, while no relapse was found in 7 patients. Conclusion: The integrated gastrointestinal nutritional tube loaded with double 125I strands can achieve gastrointestinal nutrition and brachytherapy at the same time,which is effective and safe for treating esophageal cancer and grade dysphagia.