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目的 研究放射治疗合并光动力疗法对中晚期食管癌的临床疗效。方法 6 0例中晚期食管鳞癌被随机分为 2个组。单放组 (30例 )为单纯体外放射治疗 ,剂量为DT6 0～ 6 6Gy ,6～ 7周 ;综合组 (30例 )为体外放射治疗至DT40Gy,4周时加用光动力疗法。血卟啉衍生物按 5mg kg体重的剂量静脉滴注 ,48、72h后在胃镜直视下对食管病变部位分段各行 1次光照。激光功率密度为 40 0～ 5 0 0mW cm2 ,每段光照 15min ,能量密度为 36 0～ 45 0J cm2 。结果 全部病例随访满 5年 ,6 0例中失随 3例 ,随访率为 95 .0 %。单放组和综合组 5年生存率 (按Kaplan Meier法 )分别为 16 .7%和 2 9.9% ,差异有显著性意义 (χ2 =4.5 4,P <0 .0 5 )。结论 放射治疗加光疗法优于单纯放射治疗 ,可明显提高中晚期食管癌的 5年生存率
Objective To study the clinical effect of radiotherapy combined with photodynamic therapy on advanced esophageal cancer. Methods Sixty cases of advanced esophageal squamous cell carcinoma were randomly divided into two groups. The patients in group A (30 cases) were treated with external beam radiotherapy alone. The dose was DT6 0-6 6 Gy for 6-7 weeks. The combination group (30 cases) was treated with DT40Gy in vitro and photodynamic therapy was given at 4 weeks. Hematoporphyrin derivatives by 5mg kg body weight dose intravenous infusion, 48,72h after esophageal lesion under the direct vision of each segment of the line 1 light. Laser power density of 40 0 ~ 500mW cm2, each light irradiation 15min, the energy density of 36 0 ~ 45 0J cm2. Results All cases were followed up for 5 years, 3 cases were lost in 60 cases, and the follow-up rate was 95.0%. The 5-year survival rates (by Kaplan Meier method) in the radiotherapy group and the combination group were 16.7% and 29.9% respectively, with significant difference (χ2 = 4.54, P <0.05). Conclusion Radiotherapy plus phototherapy is superior to radiotherapy alone and can significantly improve the 5-year survival rate of advanced esophageal cancer