PHOTOFRIN光动力治疗晚期鼻咽癌疗效观察

Clinical effect of photofrin photodynamic therapy for patients with nasal pharyngeal cancer

目的:探讨PHOTOFRIN光动力治疗晚期鼻咽癌的近期疗效及毒副反应。方法:30例肿瘤患者均属于临床Ⅳ期,随机分为光动力治疗组和化疗组两组,光动力治疗组光敏剂为PHOTOFRIN,按2mg/kg体重静脉滴注,48小时后经内镜导入光导纤维给以630nm的激光照射,48h后经内镜清除坏死组织并对原有病灶和新发现病灶给以复照,之后根据具体情况给患者的病灶部位清除坏死组织;化疗组给以常规顺铂和氟尿嘧啶化疗。结果:光动力组总有效率(78·6%)和腔道梗阻的缓解率均明显高于化疗组,KPS评分也有明显差异。结论:与常规化疗相比光动力治疗晚期鼻咽癌能够有效的解除腔道梗阻,毒副反应轻,耐受性好,明显改善患者的生存质量,对晚期鼻咽癌不失为一种较好的姑息治疗手段。

Objective：To evaluate the clinical efficacy and adverse effects of photofrin photodynamic therapy （PDT） in patients with nasal pharyngeal cancer under endoscope. Methods：Thirty patients with nasal pharyngeal cancer were devided illtO two groups as PDT group and chemotherapy group. In PDT group, the patients received intravenous administration of photofrin as the photosensitizer at the dose of 2 mg/kg b. w. 48h before PDT by 630 nm light （DIOMED） delivered through cylinder diffusing tip quartz fibers that passed through the biopsy channel of a flexible endoscope. PDT endoscopy was repeated, the necrotic tissue removed and, if necessary, the primary sites and other newly identified sites were subjected to a second exposure 48h later. Endoscopy was repeated one month after PDT and periodically thereafter as needed to evaluate. The routine DDP and 5-FU were given in the chemotherapy group. Results：The total remission rate （78.6%） and nasal cavity obstruction remission rate in PDT group was better than that in chemotherapy group significantly. KPS score was also significant difference between two groups. Conclusion：Photofrin PDT is effective and safe in the treatment of late nasal pharyngeal cancer compared with routine chemotherapy, which may be a good pelliative method of advanced stage cancer which can＇ t be controlled by routine methods.