Nd∶YAG激光结合局部化疗治疗食管癌  

Endoscopic Treatment of Esophageal Carcinoma with Nd∶YAG Laser and Local Chemotherapy

作　　者：徐红[1] 郑玉贵[2] 王文军 

机构地区：[1]白求恩医科大学第一临床学院,长春市130021 [2]白求恩医科大学第三临床学院 [3]吉林省双阳市医院

出　　处：《中国激光医学杂志》2001年第2期90-92,共3页Chinese Journal of Laser Medicine & Surgery

摘　　要：目的　评价Nd∶YAG激光结合局部化疗治疗食管癌的疗效。方法　食管癌患者 84例 ,其中肿块型 5 3例 ,溃疡型 31例。Nd∶YAG激光功率 6 0～ 80W ,光斑直径 0 2cm ,照射距离 0 5～ 1 0cm ,每次治疗平均能量 70 0 0J。在内镜下将光纤伸至肿瘤远端开始进行环形照射 ,边照射边向近端退出 ,照射后清除坏死组织。局部注入丝裂霉素 4～ 10mg与 5 Fu5 0 0mg(肿块型 )或平阳霉素 16mg(溃疡型 )。注射时将上述药物稀释为 10～ 2 0ml,分2 0～ 40点注射 ,每点注射 0 5ml,每 2周注射 1次 ,共 5～ 8次。治疗前后观察病灶大小 ,取材行病理检查。结果　完全效应 36例 (4 2 9% ) ,明显效应 30例 (35 7% ) ,稍有效应 15例 (17 8% ) ,无效 3例 (3 6 ) %。梗阻解除率 10 0 %。治疗中未出现骨髓抑制及肝、脾、肾功能损害。结论　内镜激光结合局部化疗治疗食管癌有较好的临床疗效 。Objective To evaluate the effect of endoscopic treatment with Nd∶YAG laser and lolal chemotherapy on esophageal cancer . Methods 84 patients with esophageal carcinoma were treated by Nd∶YAG laser with its power of 60-80 W, 0 2 cm in diameter of light spot and distance being kept at 0 5-1 0 cm. The average energy was 7 000 J. Laser irradiation was applied from distal end to proximal and of lesion. After necrosis tissue was eliminated, local injection of MMC 4 10 mg and 5 Fu 500 mg for massive type or PYM 16 mg for ulcerative type up to a total amount of 20 to 40 ml on each location was injected in 20-40 points of 0 5-1 0 ml every two weeks. Observation of lesions and pathological examination were condncted before and after the procedure. Results The therapeutic effects: CR 42 9%,PR 35 7%,MR 17 8%, and NR 3 6%. No bone marrow, splenic, pulmonary, hepatic and renal toxicity were observed. Conclutions The results of this study suggest that endoscopic Nd∶YAG laser therapy combined with local chemotherapy has better therapeutic effects on esophageal cancers and less side effects.

关 键 词：激光 化疗 食管癌 治疗 

分 类 号：R735.1[医药卫生—肿瘤]