回顾性研究光动力疗法与光动力疗法联合化疗和单纯化疗治疗晚期食管癌的效果。

Retrospective study of photodynamic therapy vs photodynamic therapy combined with chemotherapy and chemotherapy alone on advanced esophageal cancer.

机构信息

Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. li

出版信息

Photodiagnosis Photodyn Ther. 2010 Sep;7(3):139-43. doi: 10.1016/j.pdpdt.2010.06.002. Epub 2010 Jul 2.

DOI:10.1016/j.pdpdt.2010.06.002

PMID:20728836

Abstract

OBJECTIVE

To compare the short-term curative effect of photodynamic therapy (PDT), PDT combined with chemotherapy and chemotherapy alone on the advanced esophageal cancer patients.

METHODS

Retrospective analysis of 90 patients of esophageal cancer underwent PDT, PDT combined with chemotherapy and chemotherapy alone from 2004 to 2007 (stages III-IV), including 27 cases received PDT alone, 33 cases received PDT combined with chemotherapy and 30 cases chemotherapy alone. The enrolled patients were treated with intravenous administration of Photofrin as the photosensitizer at a dose of 2mg/kg. 630 nm laser irradiation was performed through optical fiber that passed through the biopsy channel of a flexible endoscope after 48 h. Two days later, the necrotic tissue was removed, and the primary sites and other newly identified lesions were subjected to a second irradiation and then the residual necrotic tissue was removed according to the patients' condition. Electronic endoscopy was performed to observe the effectiveness on tumor after 1 month. In PDT combined with chemotherapy group, chemotherapy regimen was 5-FU and DDP, administered 4 cycles after PDT and chemotherapy alone group only chemotherapy regimen 5-FU and DDP for four cycles. All the 90 patients were followed up for 2 years.

RESULTS

Symptomatic palliation rate of the PDT alone group, the complex treatment group and chemotherapy alone group was 85.2%, 93.9% and 60.0%, respectively, and effective rate under endoscopy was 85.2%, 90.9% and 63.3%, respectively, there is no statistically significant difference; the survival rate of 2 years was 29.6%, 54.5% and 16.7%, respectively, and medium survival time is longer (III stages 13 m, 22 m, 10 m; IV stages 7 m, 5m, 4m), there is statistically significant difference (p=0.046).

CONCLUSION

PDT combined with chemotherapy for the advanced esophageal cancer is superior to PDT alone and chemotherapy alone.

摘要

目的

比较光动力疗法（PDT）、PDT 联合化疗与单纯化疗对晚期食管癌患者的短期疗效。

方法

回顾性分析 2004 年至 2007 年（Ⅲ-Ⅳ期）90 例接受 PDT、PDT 联合化疗和单纯化疗的食管癌患者，PDT 组 27 例，PDT 联合化疗组 33 例，单纯化疗组 30 例。所有患者均静脉注射光敏剂 Photofrin，剂量为 2mg/kg。48 小时后，通过经内镜活检通道插入的光纤进行 630nm 激光照射。两天后，清除坏死组织，根据患者情况对原发灶和其他新发现的病变进行第二次照射，然后清除剩余的坏死组织。1 个月后，电子内镜观察肿瘤疗效。PDT 联合化疗组，PDT 后行 4 个周期 5-FU+DDP 化疗，单纯化疗组仅行 4 个周期 5-FU+DDP 化疗。90 例患者均随访 2 年。

结果

PDT 组、联合化疗组和单纯化疗组的症状缓解率分别为 85.2%、93.9%和 60.0%，内镜下有效率分别为 85.2%、90.9%和 63.3%，差异无统计学意义；2 年生存率分别为 29.6%、54.5%和 16.7%，中位生存时间较长（Ⅲ期 13m、22m、10m；Ⅳ期 7m、5m、4m），差异有统计学意义（p=0.046）。