光动力学疗法联合化疗治疗晚期贲门癌的疗效分析

Photodynamic Therapy Combined with Chemotherapy for Advanced Cardiac Cancers:a Therapeutic Effectiveness Analysis

目的总结光动力学疗法联合化疗治疗术后晚期贲门癌的近期疗效和远期疗效。方法病理检查确诊的术后晚期贲门癌患者144例,随机分为3组:第1组为PDT治疗1个月后化疗组[替加氟/尿嘧啶丝裂霉素(UFTM方案)]60例;第2组为PDT与化疗同时组30例;第3组为单纯化疗组54例。结果3组的近期疗效(CR+SR)分别为50%,70%与50%,第2组(70%)疗效明显优于其他2组(P<0.01),且不良反应不加重。随访18年内144例患者全部死亡。随访第10年仍有3例存活,其中2例是在第2组,随访第18年存活最长的1例患者死亡,该患者也是在第2组。PDT治疗1个月后化疗组和单纯化疗组存活患者的近期疗效和远期疗效比较均无显著性差异。结论PDT与化疗同时治疗晚期贲门癌的近期疗效和远期疗效均显著优于单纯化疗组和PDT治疗1个月后化疗组。

Objective To carry out a prospective study to explore the short-term and long-term therapeutic effectiveness of PDT combined with chemotherapy for postoperative patients with advanced cardiac cancers. Methods Totally 144 postoperative patients with advanced cardiac cancers were included in this study. The diagnosis of cardiac cancer was confirmed by histopathology in all 144 cases. They were randomly divided into 3 groups. Group Ⅰ of 60 cases ： chemotherapy Ⅰ tegafur/uracil and mytomycin （UFrM scheme）] started one month after PDT. Group lI of 30 cases： PDT and chemotherapy were carried out simultaneously . Group Ⅲ of 54 cases ： only chemotherapy was carried out. Results The short-term therapeutic effectiveness （ CR ＋ SR） in the 3 groups was 50%, 70% and 50%, respectively. The effectiveness of group Ⅱ was （70%） significantly better than that of the other two groups （P 〈 0.01 ） and the side effects did not become worse. The results obtained by a 18-year follow-up care demonstrated that all 144 cases died within eighteen years after the treatment. Three of them were still alive at the 10th year after the treatment （ December, 1999） and two of them were from Group Ⅱ. The patient who survived for the longest time died at the 18th year after the treatment and he was also from Group Ⅱ. Neither the short-term nor the long-term effectiveness of the group of chemotherapy started one month after PDT and the group of chemotherapy alone showed significant improvement. Conclusions The therapeutic effectiveness of simultaneous photodynamic therapy combined with chemotherapy for advanced cardiac cancer is remarkably better than that of chemotherapy alone and PDT followed by chemotherapy one month after PDT. This is demonstrated by both short-term and long-term effectiveness analysis. The results of the present study are promising and this therapeutic modality is worthy of further investigation.