中晚期食管癌放射加光疗法的临床研究

A study on radiotherapy combined with phototherapy for advanced esophageal cancer

目的 研究放射治疗合并光动力疗法对中晚期食管癌的临床疗效。方法 6 0例中晚期食管鳞癌被随机分为 2个组。单放组 (30例 )为单纯体外放射治疗 ,剂量为DT6 0～ 6 6Gy ,6～ 7周 ;综合组 (30例 )为体外放射治疗至DT40Gy,4周时加用光动力疗法。血卟啉衍生物按 5mg kg体重的剂量静脉滴注 ,48、72h后在胃镜直视下对食管病变部位分段各行 1次光照。激光功率密度为 40 0～ 5 0 0mW cm2 ,每段光照 15min ,能量密度为 36 0～ 45 0J cm2 。结果 全部病例随访满 5年 ,6 0例中失随 3例 ,随访率为 95 .0 %。单放组和综合组 5年生存率 (按Kaplan Meier法 )分别为 16 .7%和 2 9.9% ,差异有显著性意义 (χ2 =4.5 4,P <0 .0 5 )。结论 放射治疗加光疗法优于单纯放射治疗 ,可明显提高中晚期食管癌的

Objective To evaluate the effect of radiotherapy combined with photodynamic therapy on advanced esophageal cancer. Methods From October 1991 to December 1992, 60 patients with advanced esophageal cancer were randomly divided into two groups, 30 patients received radiotherapy alone (RT), the others received radiotherapy combined with photodynamic therapy (RPT). After a dose of 40?Gy, HpD(hematoporphyrin derivative ) was given i.v. at 5?mg/kg 48 and 72 hours prior to the laser irradiation. The lesions were irradiated with 630nm wave length of argon ion laser pumped by dye laser with power densities of 400～500 mW/cm 2 for 15 minutes and the energy densities were 360～450 J/cm 2. Results The 5 year survival rate was 16.7% in the RT group and 29.9% in the RPT group (P<0.05) which was significant.Conclusion Radiotherapy combined with photodynamic therapy obviously improves the survival of patients with advanced esophageal cancer .