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目的探讨光动力疗法联合支架植入的治疗模式对中晚期食管癌的临床价值。方法 11例中晚期食管癌患者于内镜直视下植入镍钛合金支架后使用光动力治疗,按照5 mg/kg静脉注射光敏剂喜泊分注射液,于24 h后在胃镜引导下使用630 nm波长的激光进行照射,功率密度150 mW/cm2,持续30 min,能量密度270 J/cm2,72 h重复照射治疗。治疗3个月、6个月、12个月后复查内镜、CT,并对临床症状、生存时间、不良反应进行观察。结果全部11例患者均随访12个月,治疗后1个月、3个月吞咽困难缓解率100%。治疗后6个月、12个月吞咽困难完全缓解率分别为82%(9/11),64%(7/11),半年生存率73%(8/11),1 a生存率54%(6/11)。结论光动力治疗联合支架植入对中晚期食管癌临床症状、生活质量有一定程度的改善,无明显的毒副反应,对晚期食管癌的治疗具有较好的临床价值。
Objective To investigate the clinical value of photodynamic therapy combined with stent implantation on advanced esophageal cancer. Methods Eleven patients with advanced esophageal cancer underwent endoscopic retrograde implantation of Ni-Ti alloy stents and then treated with photodynamic therapy. At 5 mg / kg intravenous photosensitizer, 630 nm wavelength laser irradiation, the power density of 150 mW / cm2, sustained for 30 min, the energy density of 270 J / cm2, 72 h repeated irradiation treatment. After 3 months, 6 months and 12 months of treatment, endoscopy and CT were reviewed, and the clinical symptoms, survival time and adverse reactions were observed. Results All 11 patients were followed up for 12 months. After 1 month and 3 months of treatment, the rate of dysphagia was 100%. The complete remission rates at 6 months and 12 months after swallowing were 82% (9/11) and 64% (7/11), respectively, with a half-year survival of 73% (8/11) and a survival of 54% 6/11). Conclusion Photodynamic therapy combined with stent implantation has a certain degree of improvement on the clinical symptoms and quality of life of patients with advanced esophageal cancer, with no obvious side effects. It has good clinical value for the treatment of advanced esophageal cancer.