【摘要】 目的观察单纯光动力疗法及联合手术治疗皮肤恶性肿瘤的疗效。方法 138例确诊皮肤恶性肿瘤患者,根据患者病变部位、大小、皮损侵入程度、年龄、身体状况及手术意愿,68例患者选择单纯光动力治疗,70例患者光动力联合手术治疗。结果 70例手术联合光动力治疗者,69例皮损基本消退,治愈率98.6%,其中46例先做手术,24例先做光动力治疗再行手术治疗,术后ALA-PDT治疗1~4次,平均2.2次;68例单纯行ALA-PDT治疗患者,63例皮损基本消退,治愈率92.6%,治疗次数2~7次,平均3.2次,另有5例患者未愈,但皮损较前改善;基底细胞癌(BCC)治疗2~7次,平均3.2次,鳞状细胞癌(SCC)治疗3~6次,平均3.8次,鲍温病治疗2~5次,平均3.15次,乳房外Paget治疗2~6次,平均3.6次。术后不良反应为一过性红肿或色素沉着。对BCC和SCC的手术患者、非手术患者分别行样本均数u检验(α=0.05),结果示,无论BCC还是SCC,手术患者ALA-PDT治疗次数均少于非手术患者(P<0.05);手术患者中SCC和BCC治疗次数差异无统计学意义(P>0.05),但在非手术患者中BCC治疗次数少于SCC(P<0.05)。结论单纯光动力疗法及联合手术治疗均是安全、有效的方法,联合手术治疗可以缩短治疗周期,且BCC患者治疗次数少于SCC患者。更多还原

【Abstract】 Objective To observe the clinical efficacy of photodynamic therapy(ALA-PDT) alone and in combination with surgery on skin cancers. Methods One hundred and thirty-eight patients with early skin cancer were enrolled in this study. According to the location of lesion,degree of skin invasion,age and patients’ physical condition,68 patients were treated with ALA-PDT and 70 patients were treated with ALA-PDT plus surgery. Results 69 of 70 patients(98. 6%),including 46 patients given surgery first and 24 patients receiving ALAPDT first,were cured by surgery plus ALA-PDT. The average ALA-PDT treatment times were 2. 2(1 ~ 4times); 63 out of 68 patients(92. 6%) treated with ALA-PDT alone were cured with an average of 3. 2 treatments(2 ~ 7 times). The lesions were improved in the 5 uncured patients. SCC patients were treated 3. 8 times(3 ~6 times). The average treatment times for BCC were 3. 2 times(2 ~7times),3. 15 times(2 ~5 times) for Bowen’s disease,3. 6 times(3 ~ 6 times) for extramammary Paget’s disease. Adverse reactions included temporary swelling or pigmentation. Either BCC or SCC patients treated with surgery required fewer ALA-PDT treatments than those without surgery(P<0. 05). There are no differences in ALA-PDT treatment times between BCC and SCC patients with surgery. But in patients with no surgical treatment,BCC patients needed fewer ALA-PDT treatments than SCC patients(P<0. 05). Conclusion ALA-PDT in combination with surgery is safe and effective for skin cancers. Applications of ALA-PDT after surgery can shorten treatment course. BCC patients require fewer ALA-PDT treatments than SCC patients.更多还原