Abulafi A M, Allardice J T, Williams N S, van Someren N, Swain C P, Ainley C
Department of Surgery, Royal London Hospital, London.
Gut. 1995 Jun;36(6):853-6. doi: 10.1136/gut.36.6.853.
Ten patients with ampullary carcinoma, not suitable for surgery, were treated with endoscopic photodynamic therapy (PDT) to evaluate the feasibility and safety of treatment. Patients received 4 mg kg-1 of haematoporphyrin derivative intravenously. Two days later, a duodenoscopy was performed and red (630 nm) light delivered to the tumour at fixed energy densities of 50 J or 200 J cm-1 per application, depending on the type of optical fibre used. The tumours were treated by three or four light applications at each session. Treatment was repeated up to five times at intervals of three to six months. The sole complication of PDT was moderate skin photosensitivity, which occurred in three patients. Tumour size was assessed at four to eight weekly intervals. In the absence of macroscopic tumour, biopsy specimens were taken. In three patients with small tumours confined to the ampulla, remission was obtained for periods ranging from eight to 12 months. In a further four patients with small tumours bulk was greatly reduced. There was little response in three patients with extensive duodenal involvement. Therefore PDT for ampullary carcinoma is both feasible and safe, and with refinement may prove curative for small tumours.
对10例不宜手术的壶腹癌患者进行内镜光动力疗法（PDT），以评估该治疗方法的可行性和安全性。患者静脉注射4 mg/kg血卟啉衍生物。两天后，进行十二指肠镜检查，并根据所用光纤类型，以50 J或200 J/cm²的固定能量密度向肿瘤照射红色（630 nm）光。每次治疗时，对肿瘤进行三或四次光照。治疗每三至六个月重复进行，最多重复五次。PDT的唯一并发症是3例患者出现中度皮肤光敏感。每隔四至八周评估肿瘤大小。在无肉眼可见肿瘤的情况下，采集活检标本。3例肿瘤局限于壶腹的小肿瘤患者获得了8至12个月的缓解期。另有4例小肿瘤患者的肿瘤体积大幅减小。3例十二指肠广泛受累的患者几乎没有反应。因此，壶腹癌的PDT治疗既可行又安全，经过改进可能对小肿瘤具有治愈作用。
