摘要
目的:观察光动力疗法(photodynamictherapy,PDT)联合化疗对老年人中晚期消化道肿瘤的疗效并比较其对生活质量的影响,探寻老年人中晚期消化道肿瘤的治疗方法。方法:15例选用保守方法治疗的老年中晚期消化道肿瘤,其中食管癌7例,结肠癌4例,直肠癌4例。全部患者进行内镜下PDT联合化疗,其中6例还在PDT前行内镜下肿物切除术。于治疗前及治疗后1,2,3,6,9,12个月复查内镜并进行临床症状评定,并对患者采用世界卫生组织生活质量测定量表简表WHOQOL-BREF)进行调查,随访生活质量、生存(时间,观察毒副作用。结果:15例患者平均随访时间7.5(0.5～16)个月;临床症状缓解率80%12/15);半年生存率73%(11/15),1年生存率40%6/15);中位((生存期为9个月;内镜下完全应答率27%(4/15),部分应答率为47%(7/15)。与治疗前比较,患者PDT联合化疗后3个月生理和心理领域的生活质量差异有显著性意义(F=4.307～7.899,P<0.05)。有1例出现皮肤过敏反应,副反应发生率为7%(1/15);1例食管癌患者术后1周出现大出血,并发症发生率为7%1/15)。(结论:PDT联合化疗可显著改善老年肿瘤患者的临床症状和生活质量,是治疗老年中晚期消化道肿瘤又一有效手段。
AIM:To observe the curative effect of photodynamic therapy(PDT) combined with chemotherapy on advanced gastrointestinal carcinoma, and compare the effect on quality of life(QOL)in order to explore the treatment method of treating advanced gastrointestinal carcinoma in elder patients. METHODS:Fifteen elderly patients with advanced gastrointestinal carcinoma were treated with conservative method, including 7 patients with carcinoma of esophagus, 4 with cancer of colon and 4 with rectal carcinoma.All patients were treated with PDT combined with chemotherapy under endoscope. Endoscopic debulking of the tumors was carried out in 6 patients before PDT.Treatment response of the tumors was determined by follow up endoscopies 1, 2, 3, 6, 9 and 12 months after PDT.The patients were investigated by WHOQOL BREF.The QOL and the existing time were followed up and the side effect was observed. RESULTS:The median time of the follow up period for the 15 patients was 7.5 months (0.5 to 16).The remission rate of clinical symptom was 80%(12/15).The survival rates of half a year and one year for the patients were 73%(11/15) and 40%(6/15) respectively.The melexist period was 9 months.A complete response rate was 27%(4/15) and a partial response was 47% (7/15). The differences of QOL in physiological and psychological domains were significant between pretreatment 3 months after treatment with PDT combined with chemotherapy(F=4.307 to 7.899,P< 0.05). Cutaneous photosensitization was found in one patient corresponding to a side effect rate of 7%(1/15).Major bleeding occurred in one patient with esophageal carcinoma one week later. The incidence of complication was 7%(1/15). CONCLUSION:PDT combined with chemotherapy appears to be a promising effective treatment for the middle or late staged gastrointestinal cancer,which can improve the clinical symptom and QOL of the elder patients with gastrointestinal cancer.
出处
《中国临床康复》
CSCD
2004年第26期5518-5520,共3页
Chinese Journal of Clinical Rehabilitation
