光动力学疗法与局部化疗联合治疗进展期食管贲门癌

Photodynamic therapy combined with local chemotherapy for ad-vanced esophagocardiac cancer

作者应用光动力学疗法（ＰＤＴ）对进展期食管贲门癌５５例进行治疗，并对其中１５例联合应用内镜下局部注射抗癌药物。对每一患者均先静脉滴注血卟啉衍生物（ＨＰＤ）５ｍｇ／ｋｇ，于用药后２４，４８和７２ｈ分别用波长６３０ｎｍ的铜蒸汽激光照射肿瘤部位．联合治疗组除ＰＤＴ治疗外，于每次光照前肿瘤局部注射５－Ｆｕ２５０～５００ｍｇ．结果：联合治疗组的近期显效率高于单纯ＰＤＴ组（Ｐ＜０．０５）．病例随访６～１６月，联合治疗组的平均生存期较单纯ＰＤＴ组延长（Ｐ＜０．０５）．结果表明，ＰＤＴ与局部注射５－Ｆｕ联合应用对治疗进展期食管贲门癌安全而有效，并能提高ＰＤＴ的治疗效果。

Of 55 patients with advanced esophagocadiac cancer treated with photodynamic therapy(PDT),15were treated by combination with local chemotherapy under endoscope. The PDT was carried out in 24,48and 72 h after intravenous injection of hematoporphyrin derivative(HPD)5 mg/kg,the entire tumor was ir-radiated with 630 nm copper vapour laser.In combined treatment group,besides PDT,5-Fu 250～500 mgwas locally injected prior to each irradiation.In PDT group,CR+SR occurred 9 out of 40 cases(22.5%).Incombined treatment group CR+SR occurred 8 out of l5 cases(53.3%).The rate of significant remission incombined treatment group was significantly higher than that in PDT group(P <0.05).The patients werefollowed-up for 6～16 months,the mean survival time of combined treatment group was longer than that ofPDT group (P<0. 05).These results indicate that PDT combined with local injection of 5-Fu is safe and ef-fective for advanced esophagocardiac cancers,and can improve the therapeutic effect.