光动力疗法与支架放置术治疗进展期食管癌比较  

Effect of photodynamic therapy and stent on the management of advanced esophageal cancer

作　　者：沙卫红[1] 李瑜元[1] 聂玉强[1] 黎庆宁[1] 周永健[1] 梁培智[1] 赖晓波[1] 王红[1] 佘庆珠[1] 吴惠生[1] 

机构地区：[1]广州市第一人民医院消化内科,510180

出　　处：《中华消化内镜杂志》2006年第1期27-30,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的对比光动力疗法与内镜下支架放置术对进展期食管癌的疗效和安全性。方法18例行内镜下光动力治疗，22例行内镜下支架放置术，根据患者的耐受情况辅助化疗。两组患者的年龄、性别、肿瘤大小、分期、合并症等相比，无统计学差异。对比两种治疗方法对进展期食管癌的疗效和安全性，观察毒副作用，随访生存时间。结果光动力治疗组平均随访时间6．7（0．5～19）月；临床症状缓解率77．8％（14／18）；内镜下完全应答率16．7％（3／18），部分应答率为38．9％（7／18）；半年生存率55．6％（10／18），1年生存率22．2％（4／18）；中位生存期为7个月。1例术后1周出现大出血，并发症发生率为5．6％（1／18）；未见光过敏等不良反应发生。支架术组平均随访时间3．5（1～19）月；临床症状缓解率81．8％（18／22）；半年生存率22．7％（5／22），1年生存率9．1％（2／22）；中位生存期为3个月。两组相比，半年生存率和中位生存期之间差异有统计学意义（P〈0．05）。结论光动力疗法与支架放置术均可显著改善进展期食管癌患者的临床症状，但前者更明显延长患者的生存期，是治疗进展期食管癌又一有效手段。Objective To compare the efficacy of photodynamie therapy （PDT） and stent placement on patients suffered from advanced esophageal carcinoma, Methods Eighteen patients with inoperable esophageal carcinoma underwent PDT combined with chemotherapy and twenty two patients with inoperable esophageal carcinoma were treated by stent placement under the endoscopic guidance, Treatment responses of the tumors were determined by follow-up endoseopies 1, 2, 3, 6, 9 and 12 months after PDT, Symptomatic improvement of the patients and side effects of the photosensitizer were noted, Survival data was obtained in all patients, Results The follow up period for the 18 patients treated by PDT was O. 5 to 19 months with a median time of 6,7 months, while the stent group, 3,5（ 1 -19）months. Symptomatic palliation was observed in 77, 8% （14/18）of the patients with PDT and 81.8% （18/22） of the patients with stent placement. The survival rates at half a year and one year for the patients with PDT were 55.6% （10/18） and 22. 2% （4/18） respectively with mediam survival time, 7 months, while in stent group, were 22. 7% （5/ 22） and 9. 1% （2/22）respectively with medium survival time, 3 months, In comparison of the results between two groups, the half year survival rate and medium survival time showed statistically significant difference （ P 〈 0. 05 ）. Major bleeding occurred in a patient with esophageal carcinoma one week post-PDT corresponding to a complication rate of 5.6%. Conclusion Both PDT and stent placement can improve the clinical symptoms of patients with advanced esophageal carcinoma, PDT appears to be a promising effective treatment and can prolong the survival period significantly.

关 键 词：食管癌 光动力疗法 支架 化学疗法 辅助 

分 类 号：R735.1[医药卫生—肿瘤] R473.5[医药卫生—临床医学]