食管/贲门癌内镜下光动力治疗光照时机选择的临床研究  

Clinical study of time optimizing of endoscopic photodynamic therapy on esophageal and/or gastric cardiac cancer

作　　者：冯笑山[1] 高社干[1] 陈书昌[2] 陈建民[2] 董建堂[2] 王红岩[2] 王立东[1] 

机构地区：[1]郑州大学医学院癌症研究室,河南郑州450052 [2]河南科技大学第一附属医院肿瘤科,河南洛阳471003

出　　处：《中国内镜杂志》2006年第11期1121-1124,1127,共5页China Journal of Endoscopy

基　　金：河南省医学科技创新人才工程项目(200403057);国家杰出青年科学基金(30025016);国家自然科学基金(39770296);河南省自然科学基金(0511043200)

摘　　要：目的探讨激光照射时机的选择对食管/贲门癌光动力治疗(photodynamictherapy,PDT)的近期疗效及毒副反应的影响。方法40例中、晚期食管/贲门癌按就诊先后随机分为A、B二组。A组选择光敏剂(Photofrin)静脉滴注后24和48h经内镜导入光导纤维,给以630nm(Diomed半导体激光治疗机)的激光照射750s;B组选48和72h照射,之后对比观察。结果光动力治疗后二组有效率分别为85%和75%,但差异无显著性(P>0.05);食管梗阻改善有效率分别为90%和60%,差异具有显著性(P<0.05);二组的毒副反应分别为40.2%和15.8%,差异具有显著性(P<0.01)。结论光动力能够明显改善中、晚期食管/贲门癌患者的生存质量,是一种不可缺少的治疗手段,但是一定要选择合适的治疗时机。[Objective] To evaluate the clinical efficacy and adverse effects of Photodynamic Therapy （PDT） on esophageal and/or gastric cardiac cancer during time optimizing for employing laser irradiation. [Methods] 40 patients with advanced esophageal and/or gastric cardiac cancer were divided into group A and group Bad lib. Following intravenous administration of photofrin at dose of 2 mg/kg.b.w, as the photosensitizer, 630nm laser irradiation （DIOMED） with 400 mW/cm was applied on each part of tumor for 750 seconds through cylinder diffusing quartz fibers localizing in the biopsy channel of a flexible endoscope at 24th and 48th for group A and at 48th and 72nd for group B respectively. [Results] The total rates （CR＋PR） of effective were 85% and 75% respectively in two groups after PDT with P 〉0.05; the relief rates of lumen obstruction were 90% and 60% respectively with statistical significance （P 〈0.05）; the frequency of adverse effects were 44.2% and 15.8% respectively with P 〈0.01. [Conclusions] The therapy of photofrin PDT was effective in improving life quality of patients with advanced esophageal and/or gastric cardiac cancer and the time optimizing for employing laser irradiation was of great importance.

关 键 词：食管癌 贲门癌 光动力治疗 内镜 激光照射 

分 类 号：R730.59[医药卫生—肿瘤]