Sibille A, Lambert R, Souquet J C, Sabben G, Descos F
Department of Digestive Diseases, Edouard Herriot Hospital, Lyon, France.
Gastroenterology. 1995 Feb;108(2):337-44. doi: 10.1016/0016-5085(95)90058-6.
BACKGROUND/AIMS: Photodynamic therapy (PDT) has been adapted to the endoscopic treatment of digestive cancer, but its indications and efficacy remain uncertain. The aim of this study was to assess its feasibility in the curative treatment of small esophageal tumors.
From 1983 to 1991, PDT was used to treat 123 patients with esophageal cancer who were recommended for nonsurgical treatment of squamous cell carcinoma (n = 104) and adenocarcinoma (n = 19). Endoscopic ultrasonography (EUS) was performed in 88 patients; 61 were staged uT1 and 27 were staged uT2. A hematoporphyrin derivative was injected 72 hours before laser irradiation with a 630-nm dye laser. PDT was applied alone in 56 patients and as part of a multimodal protocol in the 67 others.
The complete response rate at 6 months was 87%. The 5-year survival rate was 25% +/- 6%, and the 5-year disease-specific survival rate was 74% +/- 5%. The complete response rate and survival rate were not different (1) between the PDT alone and the PDT multimodal treatment groups, (2) between the adenocarcinoma and squamous cell carcinoma groups, and (3) between the uT1 and uT2 EUS groups. PDT-related complications were esophageal stenosis (n = 43) and cutaneous photosensitization (n = 16).
In patients with small esophageal tumors who pose high surgical risk, photodynamic therapy is an effective treatment.
背景/目的：光动力疗法（PDT）已应用于消化道癌症的内镜治疗，但其适应证和疗效仍不明确。本研究的目的是评估其在小的食管肿瘤根治性治疗中的可行性。
1983年至1991年，PDT用于治疗123例推荐进行非手术治疗的食管癌患者，其中鳞状细胞癌104例，腺癌19例。88例患者接受了内镜超声检查（EUS）；61例分期为uT1，27例分期为uT2。在激光照射前72小时注射血卟啉衍生物，使用630nm染料激光。56例患者单独接受PDT治疗，另外67例作为多模式方案的一部分接受治疗。
6个月时的完全缓解率为87%。5年生存率为25%±6%，5年疾病特异性生存率为74%±5%。（1）单独PDT治疗组与PDT多模式治疗组之间、（2）腺癌组与鳞状细胞癌组之间、（3）uT1和uT2 EUS组之间的完全缓解率和生存率无差异。与PDT相关的并发症为食管狭窄（43例）和皮肤光敏反应（16例）。
对于手术风险高的小食管肿瘤患者，光动力疗法是一种有效的治疗方法。
