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食管/贲门癌内镜下光动力治疗光照时机选择的临床研究

Clinical study of time optimizing of endoscopic photodynamic therapy on esophageal and/or gastric cardiac cancer

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【作者】 冯笑山高社干陈书昌陈建民董建堂王红岩王立东

【Author】 FENG Xiao-shan1,2, GAO She-gan1,2, CHEN Shu-chang2, CHEN Jian-min2, DONG Jian-tang2, WANG Hong-yan2, WANG Li-dong1 (1.Laboratory for Cancer Research, College of Medicine, Zhengzhou University, Zhengzhou, Henan 450052, P.R.China; 2.Oncology Department, the First Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan 471003, P.R.China)

【机构】 郑州大学医学院癌症研究室河南科技大学第一附属医院肿瘤科郑州大学医学院癌症研究室 河南郑州450052河南科技大学第一附属医院肿瘤科河南洛阳471003河南郑州450052河南科技大学第一附属医院肿瘤科河南郑州450052

【摘要】 目的探讨激光照射时机的选择对食管/贲门癌光动力治疗(photodynamictherapy,PDT)的近期疗效及毒副反应的影响。方法40例中、晚期食管/贲门癌按就诊先后随机分为A、B二组。A组选择光敏剂(Photofrin)静脉滴注后24和48h经内镜导入光导纤维,给以630nm(Diomed半导体激光治疗机)的激光照射750s;B组选48和72h照射,之后对比观察。结果光动力治疗后二组有效率分别为85%和75%,但差异无显著性(P>0.05);食管梗阻改善有效率分别为90%和60%,差异具有显著性(P<0.05);二组的毒副反应分别为40.2%和15.8%,差异具有显著性(P<0.01)。结论光动力能够明显改善中、晚期食管/贲门癌患者的生存质量,是一种不可缺少的治疗手段,但是一定要选择合适的治疗时机。

【Abstract】 [Objective] To evaluate the clinical efficacy and adverse effects of Photodynamic Therapy (PDT) on esophageal and/or gastric cardiac cancer during time optimizing for employing laser irradiation. [Methods] 40 patients with advanced esophageal and/or gastric cardiac cancer were divided into group A and group B ad lib. Following intravenous administration of photofrin at dose of 2 mg/kg.b.w. as the photosensitizer, 630nm laser irradiation (DIOMED) with 400 mW/cm was applied on each part of tumor for 750 seconds through cylinder diffusing quartz fibers localizing in the biopsy channel of a flexible endoscope at 24th and 48th for group A and at 48th and 72nd for group B respectively. [Results] The total rates (CR+PR) of effective were 85% and 75% respectively in two groups after PDT with P >0.05; the relief rates of lumen obstruction were 90% and 60% respectively with statistical significance (P <0.05); the frequency of adverse effects were 44.2% and 15.8% respectively with P <0.01. [Conclusions] The therapy of photofrin PDT was effective in improving life quality of patients with advanced esophageal and/or gastric cardiac cancer and the time optimizing for employing laser irradiation was of great importance.

【基金】 河南省医学科技创新人才工程项目(200403057);国家杰出青年科学基金(30025016);国家自然科学基金(39770296);河南省自然科学基金(0511043200)
  • 【文献出处】 中国内镜杂志 ,China Journal of Endoscopy , 编辑部邮箱 ,2006年11期
  • 【分类号】R735
  • 【被引频次】6
  • 【下载频次】104
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