内镜激光照射加局部注射化疗药治疗早期食管贲门癌的临床应用  

Endoscopic Nd∶YAG Laser Therapy Plus Local Chemotherapy of Submucosal Esophageal or Cardiac Carcinomas

作　　者：王玉梅[1,2] 黄涛[1,2] 贾建红[1,2] 孟伟 任秀娟[1,2] 

机构地区：[1]河南省新乡市中心医院 [2]中国中医研究院

出　　处：《中国激光医学杂志》1998年第2期69-72,共4页Chinese Journal of Laser Medicine & Surgery

摘　　要：为了研究探讨食管贲门粘膜下癌的非手术治疗方法，选择３１例不适宜手术或拒绝手术，而同意接受内镜ＮｄＹＡＧ激光照射加局部注射化疗药物治疗的食管或贲门粘膜下癌患者，采用输出功率３０Ｗ、脉冲时间１ｓ、光距０．５ｃｍ～１．０ｃｍ的ＮｄＹＡＧ激光器治疗。以准接触或非准接触连续扫描方式进行照射后，又用５－Ｆｕ２５０ｍｇ和丝裂霉素２ｍｇ对病灶四周及中央分点注射。经１～４次治疗后，癌细胞消失，无穿孔、出血等并发症。随访６月～１２月，全部病例均未发现癌细胞。初步结果显示：该方法有效，安全，痛苦小，费用低，可达到甚至优于外科手术的疗效，是不适宜手术或拒绝手术病人。hirty-one patients with early esophageal or gastric cardia cancers were treated by endoscopic Nd∶YAG laser irradiation and local injection of chemotherapeutic agents. All patients refused or were unsuitable for surgery. Among them, 25 cases of submucosal squamous cell carcinoma of the esophagus, 4 submucosal adenosquamous carcinoma and 2 adenocarcinoma of the gastric cardia were diagnosed by histopathological biopsy examination. The laser irradiation was performed at 30 W, with a pulse time 1s and 0.5 cm-1.0 cm from the lesions. Mitomycin in dose of 2 mg and 5Fu of 250 mg were injected into the cancer and adjacent areas via endoscope. After 1-4 sessions of treatment no cancer cell was detected by multiple biopsies and no complication (bleeding or perforation) occurred in the 31 cases. All patients have been followed up for 6-72 months, among them 5 cases for 72 months and 8 cases for 60 months are without sign of reccurrence. Our findings indicate that it is an effective, safe and economic modality and can be considered as the first choice for those patients who refuse or are unsuitable for surgery, especially for patients in elder age or poor conditions. The longterm following up is still under way.

关 键 词：药物疗法 内镜 粘膜下癌 食管贲门癌 激光疗法 

分 类 号：R735.105[医药卫生—肿瘤]