内镜光动力微创疗法治疗胆管癌的临床疗效分析

【摘要】〓目的〓探讨内镜光动力微创疗法(PDT)联合支架置入术治疗胆管癌的临床疗效。方法〓将2005年10月至2009年6月我院收治的62例胆管癌患者分为两组,对照组32例,给予内镜下支架置入术;治疗组30例,在支架置入术的基础上,给予内镜下光动力治疗。对62例晚期胆管癌患者的生存时间及生活质量进行随访。 结果〓经过3年以上的随访,治疗组中位生存时间18个月,1、2、3年生存率分别为63.3%、43.3%及20.0%;对照组中位生存时间8个月,1、2、3年生存率分别为43.8%、25.0%及9.4%,生活质量FACT-Hep量表术后6个月、9个月及12个月,治疗组量表总分明显高于对照组(P<0.05),术前胆红素水平、远处转移及治疗方法是影响胆管癌患者生存期的独立预后因子。结论〓内镜光动力微创疗法(PDT)联合支架置入术提高了胆管癌患者的生存率,改善了生活质量,是胆管癌一种有效的治疗方法。

Clinical efficacy of endoscopic photodynamic therapy on cholangiocarcinoma

Objective To evaluate the efficacy of endoscopic photodynamic therapy combined with stent implantation on cholangiocarcinoma. Methods Sixty-two cases of patients with cholangiocarcinoma from October 2005 to June 2009 in our hospital were divided into two groups, 32 cases in the control group were treated by endoscopic stent placement, and 30 cases in the treatment group were treated with the endoscopic stent placement combined with photodynamie therapy. The follow-up was done in 62 cases, including survival time and quality of life. Results After 3years of follow-up, the median overall survival time of treatment group was 18 months, the 1-, 2- and 3-year survival rate were 63.3%, 43.3%, and 20.0%, respectively. The median overall survival time of control group was 8 months, the 1-, 2- and 3-year survival rate were 43.8%, 25.0% and 9.4%, respectively. The total score of FACT-Hep scales in treatment group were higher than those in control group at postoperative 6 months, 9 months and 12 months （P〈0.05）. Cox multivariate analysis demonstrated that among the factors analyzed, the level of bilirubin, lymph node status, and therapeutic method were independent prognostic factors for overall survival in patients with cholangiocarcinoma. Conclusion Endoscopic photodynamic therapy combined with stent implantation improves survival and quality of life, and is an effective treatment for patients with cholangiocarcinoma.