气道恶性肿瘤患者光动力治疗24例临床分析

Clinical analysis of photodynamic therapy in 24 patients with airway malignant tumors

目的回顾性分析经电子支气管镜腔内激光光动力疗法(photodynamic therapy,PDT)治疗的气道恶性肿瘤患者临床资料,探讨PDT治疗的规律性。方法选择2019年2月至2021年3月由我院呼吸与危重症医学科进行PDT治疗的气道恶性肿瘤患者24例,分别对一般临床资料、PDT治疗情况和治疗后随访,以及治疗后存活患者和死亡患者的特征进行分析。结果截止2021年8月7日,PDT治疗后获益最大的患者随访时长达13.2个月,远远大于PDT治疗后获益较小患者的随访时长总生存期(overall survival,OS)4.7个月(P=0.02)。前者以管腔壁型为主(80%),而后者以管腔内型为主(50%)(P=0.034)。前者腔内病变短于后者(中位数分别是3 cm和5 cm,P=0.03)。前者年轻、病程短、以腺样囊性癌为主,而后者年龄大、病程长、以鳞癌为主(P>0.05)。结论管腔壁型、气道腔内病变短,以及年轻、病程短和肺腺样囊性癌的气道恶性肿瘤患者可能在PDT治疗中获益较多;相反,管腔内型、气道腔内病变长,以及年老、病程长和非肺腺样囊性癌的气道恶性肿瘤患者可能在PDT治疗中获益较少。

Objective The clinical data of patients with airway malignant tumors treated by electronic bronchoscope intracavitary laser photodynamic therapy(PDT)were analyzed retrospectively,to explore the regularity of PDT treatment.Methods 24 patients with airway malignant tumors treated by PDT were recruited in the Department of Respiratory and Critical Care Medicine of our hospital from February 2019 to March 2021.The general clinical data,PDT treatment and follow-up after treatment,as well as the characteristics of living and dead patients after treatment were analyzed.Results As of August 7,2021,the patients with the greatest benefit after PDT treatment had been followed up for 13.2 months,which was much longer than length of follow-up in patients with less benefit after PDT treatment[the overall survival(OS)of 4.7 months](P=0.02).The former was mainly lumen wall type(80%),while the latter was mainly lumen type(50%)(P=0.034).The intraluminal lesions in the former were shorter than those in the latter(median 3 cm and 5 cm,respectively,P=0.03).The former was young,short course of disease and mainly adenoid cystic carcinoma,while the latter was old,long course of disease and mainly squamous cell carcinoma(P>0.05).Conclusion Patients with lumen wall type,short airway lesions,young,short course of disease and pulmonary adenoid cystic carcinoma may be benefit more from PDT treatment.On the contrary,patients with intraluminal type,long airway lesions,old age,long disease course and non-pulmonary adenoid cystic carcinoma may be benefit less from PDT treatment.