胃镜下光动力疗法治疗上消化道肿瘤(14例)疗效分析

Effectiveness of photodynamic therapy under endoscope in patients with upper gastrointestinal carcinomas

目的评价胃镜下光动力疗法治疗上消化道恶性肿瘤的适应证、疗效和安全性。方法上消化道肿瘤患者14例。其中胃癌7例,食管癌7例。静脉注射光敏剂photosan(2mg/kg)48小时后、血啉甲醚(5mg/kg)24小时后应用氦氖激光经胃镜对病灶部位进行照射,治疗1月后复查胃镜观察病灶变化。结果 14例患者的显效率为78.6%,总有效率为92.9%,食管癌患者显效率为85.7%,胃癌患者显效率为71.4%。两种疾病之间的总有效率无显著性差异(P>0.05)。治疗的主要不良反应有反酸、恶心以及照射部位疼痛。结论光动力治疗上消化道肿瘤适用于不宜手术切除的晚期或高龄食管癌和胃癌患者,近期的局部疗效显著,是一种安全的肿瘤治疗方法。

Objective To evaluate the indications, effectiveness and safety of photodynamic therapy （PDT） under endoscope on patients with upper gastrointestinal carcinomas. Methods Fourteen patients were included in this study, 7 with esophagus carcinoma and 7 with gastric carcinoina. Forty-eight hours ＇,after intravenous injection of photosensitizer photosan （2mg/kg） or 24h after intravenous injection of photosensitizer hermimether （5mg/kg）, He-Ne lasers irradiation were performed by gastric endoscope to local tumor tissues. The regression or progression of cancer was re-evaluated one month later by gastric endoscope. Results The rate of complete and significant remission was 78.6%, and the total effective rate was 92.9%. The rate of complete and significant remission were 85.7% and 71.4% in esophagus and gastric carcinoma, respectively （P 〉 0. 05）. The main side effects were acid regurgitation, nausea, and pain in radiation region. Conclusion PDT is an alternative choice for patients with advanced age or at advanced cancers stages. It has good local effectiveness with minimal complications.