摘要
目的 探讨金蒸汽激光用于光动力疗法治疗进展期或术后复发的上消化道癌的近期疗效及毒副反应。方法 进展期或术后复发上消化道癌患者 35例 ,男性 2 7例 ,女性 8例 ,平均 6 5岁。采用IEAu 3型金蒸汽激光治疗机 ,激光波长为 6 2 7 8nm ,脉冲频率 5 5～ 6 0kHz,脉宽 40× 10 - 9～ 5× 10 - 9s,脉冲能量 70～ 80kW ,柱状光纤末端输出功率密度为 40 0～42 0mW cm2 ,能量密度 2 90～ 30 0J cm2 。HpD为光敏剂 ,按 5mg kg体重于激光照射前 12～ 2 4h静脉滴注。疗效分级采用全国与国际通用标准。结果 完全效应 16例 (占 45 7% ) ,明显效应 7例 (占 2 0 0 % ) ,稍有效应 7例 (占 2 0 0 % ) ,无效 5例 (占 14 3% )。总有效率 (CR+PR)为 6 5 7%。 3例出现较明显局部疼痛 ,3例有局部刺激症状 ,其余患者未出现明显毒副反应。结论 金蒸汽激光光动力疗法治疗进展期或术后复发的上消化道癌疗效肯定 ,毒副反应轻 ,耐受性好 。
Objective To evaluate the clinical efficacy and adverse effects of gold vapor laser irradiation in photodynamic therapy in patients with advanced cancers or postoperative local recurrence in the upper gastrointestinal tract. Methods 35 patients with advanced cancers or postoperative local recurrence in the upper gastrointestinal tract were treated by photodynamic therapy with a gold vapor pulsed laser. The wavelength of the red light was 627 8 nm, the power density and energy density used in the treatment were 400-420 mW/cm 2 and 290-300 J/cm 2, respectively. Hematoporphyrin derivative (HpD) was used as photosensitizer, which was given in a dose of 5 mg/kg intravenously 12-24 hours before irradiation. The quartz fibre was passed through the biopsy channel of a fiberscope. The treatment was divided into 2-4 segments irradiated for 12 min each according to the size of the lesions. The patients were reexamined by endoscopy and biopsy 4 weeks after the treatment in order to evaluate the clinical efficacy. Results Evaluation of the 35 patients included in this group showed that 16 patients (45 7%) had a complete response (CR), 7 (20 0%) had a partial response (PR), 7 (20 0%) had a mild response (MR), while 5 (14 3%) had no response (NR). The total response rate (CR+PR) was 65 7%. There was no significant adverse effect in this group. Conclusions Irradiation with gold vapor pulsed laser is effective and safe in photodynamic therapy for patients with advanced cancers and postoperative recurrence in the upper gastrointestinal tract.
出处
《中国激光医学杂志》
CAS
CSCD
2001年第1期25-27,共3页
Chinese Journal of Laser Medicine & Surgery
关键词
激光
光动力学疗法
血卟啉衍生物
上消化道肿瘤
治疗
Laser
Photodynamic therapy
Hematoporphyrin derivative
Upper gastrointestinal tumor
