Ding Y, Li W, Li B, Zhang W, Peng L J, Bai N F, Hu X K
Department of Gastroenterology, Qingdao Huangdao District Central Hospital, Qingdao 266555, China.
Department of Interventional Radiology, the Affiliated Hospital of Qingdao University, Qingdao 266000, China.
Zhonghua Yi Xue Za Zhi. 2020 Feb 11;100(5):378-381. doi: 10.3760/cma.j.issn.0376-2491.2020.05.012.
To compare the safety and efficacy of photodynamic therapy (PDT) and esophageal stent implantation in improving dysphagia caused by malignant obstruction of middle and advanced esophageal cancer. A total of 45 patients treated in the Affiliated Hospital of Qingdao University and Qingdao Huangdao District Central Hospital from January 2017 to January 2018 were retrospectively analyzed, of which 34 cases were males and 11 cases were females, 29 cases with the age beyond 60 years old, 41 cases were squamous carcinoma, 4 were adenocarcinoma. PDT was applied to 20 patients and 25 patients received esophageal carotid stenting implantation. There was no significant difference in gender, age, pathological type, location and stage between the two groups. Before treatment, 3 days, 1 month and 3 months after treatment, dysphagia was compared according to Stooler grading criteria, and also the time that patients experienced dysphagia again post treatment. There were no statistical differences between the two groups in dysphagia grade change in 3 days, 1 month and 3 months after treatment (all 0.05), The stent groups showed advantages towards the PDT group 3 days after treatment in patients with Stooler grading 0 (40%(10/25) vs 0(0/20), 0.05). No significant differences were found between two groups with Stooler grading 0 (0.05) in 1 month and 3 months after treatment. Obstruction symptoms occurred earlier in the stent group compared with the PDT group (0.05). Esophageal stent can relieve the symptoms of dysphagia immediately after the implantation, while photodynamic therapy can also prolong the time of esophageal re-obstruction in addition to the immediate effect, with proved safety and efficacy in the treatment of middle and advanced esophageal cancer.
比较光动力疗法（PDT）与食管支架植入术改善中晚期食管癌恶性梗阻所致吞咽困难的安全性和有效性。回顾性分析2017年1月至2018年1月在青岛大学附属医院和青岛市黄岛区中心医院接受治疗的45例患者，其中男性34例，女性11例，年龄60岁以上29例，鳞状细胞癌41例，腺癌4例。20例患者接受PDT治疗，25例患者接受食管颈动脉支架植入术。两组在性别、年龄、病理类型、部位和分期方面无显著差异。治疗前、治疗后3天、1个月和3个月，根据Stooler分级标准比较吞咽困难情况，并比较患者治疗后再次出现吞咽困难的时间。两组治疗后3天、1个月和3个月吞咽困难分级变化无统计学差异（均P>0.05），治疗后3天，在Stooler分级为0的患者中，支架组优于PDT组（40%（10/25）对0（0/20），P<0.05）。治疗后1个月和3个月，两组Stooler分级为0的情况无显著差异（P>0.05）。支架组梗阻症状出现时间早于PDT组（P<0.05）。食管支架植入后可立即缓解吞咽困难症状，而光动力疗法除即刻效果外，还可延长食管再次梗阻时间，在中晚期食管癌治疗中安全有效。
