光动力及光动力联合重组人白介素-2治疗中晚期食管癌30例

Photodynamic therapy alone or combined with recombinant human interleukin-2 in treatment of advanced esophageal carcinoma: Analysis of 30 cases

目的:探讨光动力联合重组人白介素-2(interleukin-2,IL-2)对中晚期食管癌临床预后的影响.方法:将30例中晚期食管癌患者随机分为2组,其中15例仅行单纯光动力治疗(photodynamic therapy,PDT);15例行PDT联合IL-2肌肉注射,对所有患者进行不良反应监测,复查内镜随访治疗结束后3、6 mo、1年局部复发患者数,随访1年死亡例数.结果:发热发生率B组较A组升高(93.3%vs53.3%,P<0.05),胸痛、咳嗽、咳痰发生率两组差异无统计学意义;随访6 mo局部控制率B组优于A组(6.7%vs 13.3%),差异无统计学意义;1年局部控制率B组优于A组(14.3%vs53.8%,P<0.05);1年生存率B组高于A组(73.3%vs 53.3%),但差异无统计学意义.结论:PDT联合IL-2治疗模式发挥了免疫协同效应,改变肿瘤微环境,免疫效应扩大,降低肿瘤复发,不良反应轻微,显示了良好临床前景,值得临床推广.

AIM：To evaluate the impact of photodynamic therapy combined with interleukin-2（IL-2） on the prognosis of advanced esophageal cancer.METHODS：Thirty patients with advanced esophageal cancer were collected and randomly divided into two groups：A and B.Group A（15cases） was treated by photodynamic therapy（PDT） alone,and group B（15 cases） was treated by PDT combined with intramuscular injection of IL-2.Adverse reactions were recorded.The local control rates at 3 mo,6 mo and 1 year,and survival rates at 6 mo and 1year were calculated and compared between the two groups.RESULTS：The incidence rate of fever was significantly higher in group B than in group A（93.3%us 53.3%,P〈0.05）.The incidence rates of chest pain,cough,and expectoration did not differ significantly between the two groups.The local control rate at 6 mo was better in group B than in group A,but there was no statistically difference（6.7%us 13.3%,P〈0.05）.The local control rate at 1 year was significantly better in group B（14.3%us53.8%,P〈0.05）.The survival rate at 1 year was higher in group B than in group A（73.3%us 53.3%）,but there was no statistically difference.CONCLUSION：Photodynamic therapy and IL-2 have synergistic effects on advanced esophageal cancer,which can change tumor microenvironment,enhance immunity and reduce tumor recurrence,and adverse reactions are mild.