| Background Esophageal carcinoma is a common disease in clinic, when it is been finally diagnosed, 80% patients are progressing to metaphase and later stage. To those patients who fail to undergo surgery or will not accept radioactive treatment, the placement of esophageal stent with membrane, being able to alleriate the symptom of dysphagia, does not kill the tumor. The curative effect of esophageal stent relieving esophageal stenosis or esophageal fistula has been confirmed sufficiently. On the other hand, the therapeutical effect of 125I seed placing in tissue on neoplasm has also been confirmed in clinic. It is considered to be safe and effective to place 125I seed in lesion focus directly by surgery in patients with esophageal carcinoma. Whether or not the placement of the esophageal stent with or without membrane binding 125I seed to the lesion site using interventional technique can reach the goal of removing dysphagia and killing tumor tissue? Therefore, The author undertook series of investigation on development of esophageal 125I seed irradiated stent,animal experiment and clinical application. Objective To investigate the feasibility of developing the esophageal irradiating esophageal stent by placing 125I seed into it, the safety of the irradiative stent esophageal in animal experiments and the curative effect and safety of the irradiative stent esophageal treating patients with esophageal carcinoma in clinical application.Methods 1. Development of esophageal 125I seed irradiated stent: Four choises of producing specimen of esophageal 125I seed irradiated stent were compared and the best one was determined according to the experiments of filling and releasing seeds in vitro. The animal experiment and clinical trial were carried out, to improve and to consummate the structure of esophageal irradiated stent. 2. Animal experiment: 36 rabbits were randomly assigned to 4 groups according to different irradiated dosage, 9 rabbits in each group. Intraluminal irradiated stents each with two 125I seeds totaling 0.3mCi (Group A), 0.6mCi(Group B)and 0.9mCi(Group C) respectively were placed in the rabbits esophagus and stents without 125I seeds were placed in Group D rabbits esophagus which as control group. 3 rabbits of each group were killed in the 2th, 4th, or 8th week after insertion of the stents, followed by esophageal contrast exam and CT scan to observe displacement of stents and transposition of 125I seed. The damage and its degree of esophagus and the lung,bronchus and large vessels around it caused by intraluminal irradiated stents were observed macroscopically or under optical and electronical microcopy. 3. Clinical application: Esophageal intraluminal irradiated stents with 125I seeds 10士4.2mCi whose activity was 0.6~0.8mCi were placed in 15 patients with esophageal cancer of Ⅱ-Ⅳ grade esophageal carcinoma in clinic. Total body ECT, hemogram, immunity marker, focus CT and gastroscopy were reviewed in the first week and the first, second, third and 6th month after insertion of the stents and were compared with preoperative ones respectively. The clinical curative effect was observed.Results 1. Development of esophageal intraluminal irradiated stents: micromemory-alloy-filum of 0.16mm diameter was wreathed regularly or a plastic "bullet chamber" was moulded which held only one 125I seed. Its distribution and the spot where it was stitched on outside the stents depended upon the site and range of the underlying disease. Thus esophageal intraluminal irradiating stents were developed. 2. Animal experiments: The esophageal wall near 125I seed thickened most distinctly in experimental groups during the 8th week. There was a significant difference between the experimental group and control group (p<0.05), but not among experimental groups, while during 4 weeks after the produce, no other noticeable changes of thickness occurred among the 4 groups except esophageal bore size narrowed progressively along with time The macroscopical observation on lung, trachea and thoracic aortal...
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