光动力疗法联合适形调强放疗治疗肿瘤的临床研究

Photodynamic Therapy Combined with IMCRT for Cancer:a Clinical Study

目的探讨局部光动力疗法(photodynamic therapy,PDT)联合区域适形调强放疗(intensity modulated comformed radiotherapy,IMCRT)治疗的剂量效应,为中晚期肿瘤患者提供不同策略的有效综合治疗依据。方法对手术失败或无手术适应证的空腔或浅表肿瘤患者,采用局部区域的综合治疗手段,观察PDT治疗在不同时间、能量密度、分次(TDF)与IMCRT/中医药治疗的量效关系。即分析在一定能量密度下照射20min/次、30min/次或照射1次、3次,以及不同能量密度即200J/cm2、300J/cm2下PDT治疗与疗效之间的关系。结果PDT联合IMCRT和中医药治疗肿瘤,随着TDF的变化有显著统计意义,PDT对中晚期肿瘤特别是空腔脏器患者,减轻症状提高生活质量是肯定的,对梗阻型、放化疗失败的中晚期肿瘤患者有较高的姑息治疗价值。结论采用PDT、IMCRT与中药不同策略的综合治疗,通过TDF的优化方案,创伤性小、不良反应少,可达到减毒增效带瘤生存的目的,使中晚期肿瘤患者"变不治为可治"。

Objective To mvestigate the dose effect of photodynamic therapy（PDT） combined with regional intensity modulated conformed radiotherapy （IMCRT）on intermediate and advanced cancer. Methods Ninety carcinoma patients who were after operation failure or without surgery indications, received PDT and IMCRT or traditional Chinese materia medica（TCMM）. They were divided randomly into different groups according to time duration, dose and fractionation （TDF）. Results The PDT combined with＇IMCRT and TCMM for intermediate and advanced cancer espacially for hollow viscus tumor could decrease the symptoms and improve the patients life quality. Futhermore it could be quick for tissue to relief the obstructive carcinoma. Conclusions The photodynamic therapy with IMCRT and TCMM is lessy vulnerable and seldom side reaction. It could improve the patients life quality and offer an effective method for intermediate and advanced carcinoma patients.