中国普外基础与临床杂志

中国普外基础与临床杂志

光动力疗法在不可切除肝门部胆管癌中的应用

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目的 探讨光动力疗法(PDT)在不可切除的肝门部胆管癌中的应用价值。 方法 搜索 PubMed、MedLine、Embase、CNKI 及万方数据库,对其中关于 PDT 在不可切除的肝门部胆管癌中应用情况的相关文献进行综述。 结果 PDT 在不可切除的肝门部胆管癌治疗中主要是联合胆管支架或化疗应用,能使肿瘤降期,明显降低黄疸,改善患者的生存质量,提高生存率,并且能使支架通畅时间延长且可重复治疗,对于年老、体质差、不能耐受手术的患者,理论上可代替肝门部胆管癌的 R1 或 R2 手术,规避手术风险和术后并发症;PDT 的治疗效果与早期治疗及治疗次数有一定的关系,与 PDT 引导治疗方式无关,但是 PDT 的最大缺陷是其肿瘤杀伤深度较浅以及有一定的不良反应发生率。 结论 PDT 联合支架或化疗治疗不可切除的肝门部胆管癌患者的效果优于单独治疗,其有望成为晚期肝门部胆管癌姑息性治疗的一线治疗方案。

Objective To explore application value of photodynamic therapy (PDT) in treatment of unresectable hilar cholangiocarcinoma. Method The literatures about PDT in the treatment of the unresectable hilar cholangiocarcinoma in the PubMed, MedLine, Embase, CNKI, and Wanfang databases were reviewed. Results The PDT combined with stent or chemotherapy was the main methods in the treatment of the unresectable hilar cholangiocarcinoma, which could make the tumor down-staging, obviously reduce the jaundice, improve the quality of life, improve the survival rate, and the stent patency prolonged and be repeated treatment; Especially, it was suitable for the patients with elderly, poor health, intolerance of surgery, could partly replace the R1 or R2 operation of hilar cholangiocarcinoma and avoid the risk of surgery and postoperative complications. The therapeutic effective of the PDT was related to the early therapy and times of therapy. However, the shortcomes of PDT were that the depth of killing tumor was not enough and there was a certain incidence of adverse reaction. Conclusion Therapeutic effect of PDT combine with stent or chemotherapy for unresectable hilar cholangiocarcinoma is better than that of single therapy. It is expected to be a first-line scheme of palliative treatment for unresectable hilar cholangiocarcinoma.

关键词: 肝门部胆管癌; 不可切除; 光动力疗法

Key words: hilar cholangiocarcinoma; unresectable; photodynamic therapy

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