【摘要】 目的观察X线透视引导下光动力治疗(FGPDT)用于食管癌重度梗阻的可行性。方法对20例纤维内镜无法通过的食管癌重度梗阻患者行FGPDT;统计治疗误差。于术前及术后3天、1周、1个月采用Stooler吞咽困难分级法评定吞咽困难程度;术后1个月评价治疗效果;采用CTCAE V4.0评估不良反应。结果术前、术中与术后治疗误差分别为(1.23±0.42)mm、(0.96±0.52)mm及(1.39±0.47)mm。术后3天Stooler分级与术前差异无统计学意义(P>0.05),术后1周、1个月Stooler分级较术前降低(P均<0.01)。术后1个月20例均达到部分缓解。术后19例出现轻度发热,16例手术部位食管疼痛,11例恶心,1例呕吐,均为1或2级不良反应,后自行缓解;未发生食管瘘和3级以上严重不良反应。结论 X线透视引导下FGPDT治疗食管癌重度梗阻安全、可行。更多还原

【Abstract】 Objective To observe the feasibility of fluoroscopy-guided photodynamic therapy(FGPDT) for severe obstructive esophageal cancer. Methods FGPDT was performed in 20 esophageal cancer patients with fiberoptic endoscope failed passing severe obstruction. The treatment errors were counted. Stooler dysphagia grading was used to evaluate the degrees of dysphagia before and 3 days, 1 week and 1 month after treatment. The therapeutic effect was observed 1 month after treatment, and CTCAE V4.0 was used to evaluate adverse reactions. Results The preoperative, intraoperative and postoperative treatment errors was(1.23±0.42) mm,(0.96±0.52) mm and(1.39±0.47) mm, respectively. There was no statistical significant difference of Stooler grading 3 days after treatment(P>0.05), while Stooler grading 1 week and 1 month after treatment were lower than that before treatment(both P<0.01). Partial remission achieved in all 20 patients 1 month after treatment. Mild fever and esophageal pain occurred in 19 and 16 patients, respectively, while nausea in 11 patients and vomiting in 1 patient after treatment, all were grade 1 or 2 adverse reactions and spontaneously relieved. No esophageal fistula, grade 3 nor more serious adverse reactions occurred. Conclusion FGPDT was safe and feasible for severe obstructive esophageal cancer.更多还原