ALA-PDT治疗皮肤癌的临床效果

Clinical effect of ALA-PDT in the treatment of skin cancer

目的探讨5-氨基酮戊酸光动力疗法(ALA-PDT)治疗皮肤癌的效果。方法选取80例皮肤癌患者,根据患者是否采用ALA-PDT治疗分为联合组(ALA-PDT+手术治疗)43例、单纯手术组(单纯手术治疗)37例,对比两组疗效及复发情况。结果联合组43例患者均完成了ALA-PDT治疗,其中治疗显效38例(88.37%)、有效5例(11.63%);联合组的术前病灶面积与单纯手术组比较,差异无统计学意义(P﹥0.05);联合组的手术创面面积小于单纯手术组,外观满意度高于单纯手术组,差异均有统计学意义(P﹤0.05);联合组术后12个月的复发率为9.30%,24个月的复发率为18.60%,单纯手术组分别为16.22%、35.14%,两组比较差异无统计学意义(P﹥0.05);联合组术后疾病无进展生存时间为22个月,单纯手术组为20个月,两组比较差异无统计学意义(P﹥0.05)。结论ALA-PDT结合手术治疗皮肤癌有利于减小手术创面面积,对患者术后创面外观恢复有利,但是对皮肤癌患者的远期疗效尚需进一步延长随访时间进行观察。

Objective To investigate the effect of 5-aminolevulinic acid photodynamic therapy （ALA-PDT） in the treatment of skin cancer. Method A total of 80 cases of skin cancer patients who received either ALA-PDT＋surgery （n=43） or surgery alone （n=37） were included in the analysis, and the clinical effect and recurrence in the two groups were compared. Result All the 43 patients in combined therapy group had completed ALA-PDT treatment, in which 38 cases （88.37%） had response, and 5 （11.63%） were cured;the lesion area were similar between the two groups before treatment （P〉0.05）, while the surgical wound area was less in in combined therapy group than that of single surgery group （P〈0.05）, with higher satisfaction rate for appearance observed in the combined therapy group （P〈0.05）;the recurrence rate was 9.30%and 18.60%in combined therapy group in 12 and 24 months after surgery, and was 16.22%and 35.14%in sur-gery group, respectively, though the difference was not statistically significant （P〉0.05）; the disease-free survival time was 22 months and 20 months in combined therapy group and single surgery group, respectively, which was of no statisti-cally significant difference （P〉0.05）. Conclusion ALA-PDT combined with surgery may reduce the area of the surgical wound in the treatment of skin cancer, facilitating the recovery of appearance after surgery, though the long-term effect should be further determined in extended follow-up.