食管癌放射治疗加光动力疗法长期生存分析

Analysis of Long Term Survival Rate on Radiotherapy Combined With Photodynamic Therapy for Advanced Esophageal Cancer

目的 评价放射治疗合并光动力疗法对中晚期食管癌的临床长期疗效。方法 1991年 10月至 1992年 12月 ,60例中晚期食管鳞癌被随机分为两组。对照组 :3 0例 ,常规体外放射治疗DT60 -66Gy/6-7周 ;综合组 3 0例 ,体外放射治疗同对照组 ,当DT40Gy/4周时加用光动力疗法 (PDT)。血卟啉衍生物 (HpD)按 5mg/Kg的剂量静脉滴注 ,48h、72h后在胃镜直视下对食管病变部位分段各行一次光照。波长为 63 0nm的红光 ,输出功率 40 0～ 5 0 0mW /cm2 ,每段光照时间 15min。结果 全部病人随访满 10年 ,60例中失访 3例 ,随访率 95 0 %。对照组和综合组 5年生存率分别为 16 7%、2 9 9%,10年生存率分别为 10 0 %、16 7%差异有显著意义(P <0 0 5 )。结论 放射治疗加光动力疗法优于单纯放射治疗 。

Objective To evaluate the long term curative effects of radiotherapy combined with photodynamic therapy on the advanced esophageal cancer.Methods From Oct 1991 to Dec 1992, 60 patients with advanced esophageal cancer were randomly divided into two groups, 30 patients received conventional radiotherapy alone (CRT), the other 30 cases received radiotherapy combined with photodynamic therapy (PRT). After PRT the total dose of 40Gy,for 4 weeks the hematoporphyrin derivate(HpD) was given using 5mg/kg body intravenously and after 48 and 72 hours,the location of lesion were irradiation by 630-nm red light with 400～500mW/cm 2. Laser irradiation was given for 15 minutes to each part of tumor.Results The 5,10-year survival rates were 16 7% ,10 0% respetively;for CRT group and 29 9%, 16 7% respectively; for PRT group, The difference was significant (P<0 05).Conclusion Radiotherapy combined with photodynamic therapy could obviously enhance the long term survival rate of the patients with advanced esophageal cancer .