中晚期食管癌光动力治疗联合化疗的回顾性研究

目的比较中晚期食管癌的单纯光动力治疗与光动力＋化疗联合治疗的短期疗效，探讨中晚期食管癌光动力＋化疗的治疗模式的优势。方法回顾性分析我院自2002年至2005年期间光动力治疗及光动力＋化疗治疗的食管癌患者60例（Ⅲ～Ⅳ期），其中单纯光动力治疗27例，光动力＋化疗治疗33例。光动力治疗使用光敏剂Photofrin 2mg／kg，48h后内镜引导下使用波长为630nm的激光照射，综合治疗组化疗方案为5-FU＋DDP，动力治疗后1周开始化疗，共化疗4周期。结果60例病人随访时间全部满2年，综合治疗组和单纯光动力治疗组症状缓解率分别为85．2％、93．9％，内镜评价有效率分别为85．2％、90．9％，无明显差异；2年生存率分别为54．5％、29．6％，综合治疗组中位生存期明显延长（Ⅲ期为22m、13m；Ⅳ期为7m、5m），差异有统计学意义（P=0．046）。结论光动力＋化疗治疗中晚期食管癌优于单纯光动力治疗，短期疗效相当，2年生存期有优势。

Retrospective Study of Photodynamic Therapy vs Photodynamic Therapy Combined with Chemotherapy on the Advanced Esophageal Cancer

Objective To compare the short term curative effect of photodynamic therapy （PDT） vs PDT combined with chemotherapy on the advanced esophageal cancer, and discuss the superiority of PDT combined with chemotherapy for esophageal cancer. Method Retrospective analysis of sixty patients with esophageal cancer underwent PDT or PDT combined with chemotherapy from the years of 2002 to 2005 （stage Ⅲ to stage Ⅳ）, including 27 cases received PDT alone, and 33 cases received PDT combined with chemotherapy. PDT was administrated with Photofrin 2 mg/kg, and after 48 hours the location of lesion were irradiated by 630nm-laser light under the endoscopic guidance. For the combined treatment, 5-FU plus DDP was administrated for four cycles after PDT. Result All the 60 patients were followed up for two full years. Symptomatic palliation rates of the combined treatment group and the PDT alone group are 85.2% and 93.9%, respectively ; and effective rates by the endoscopic are 85.2% and 90.9%, respectively. There is no statistically significant differences in the symptomatic palliation rates and effective rates between two treatments. However, the survival rates of two years of the combined treatment group （54.5%） is significantly higher than the PDT alone group （29.6%）, and with a longer medium survival （stage Ⅲ , 22 m vs 13 m; stage Ⅳ 7 m vs 5 m,P=0.046）. Conclusion PDT combined with chemotherapy for the advanced esophageal cancer is superior to PDT alone, with longer survival time of two years.