光動力治療中央氣道惡性腫瘤的療效觀察

楊敏玉 曾俊莉 廖俊雄 黃銳

[摘要] 目的 分析光動力治療（PDT）在中央氣道惡性腫瘤的有效性和安全性。 方法 回顧性分析2015年10月至2020年10月中央氣道惡性腫瘤患者的臨床資料，對比PDT治療前后氣道狹窄、氣促等的差異，并觀察并發癥。結果 共收集中央氣道惡性腫瘤患者12例，其中2例患者接受2次PDT，其余患者均接受1次PDT。PDT治療1個月后，氣道狹窄由25%（25%，75%）下降至0（0，40%），P=0.001，氣促評分由1（0，4）分下降至 0（0，2）分，P=0.011，完全緩解2例（16.7%）、部分緩解8例（66.7%）、疾病穩定1例（8.3%）、疾病進展1例（8.3%）。所有病例隨訪至2021年2月28日，中位隨訪時間為9.85個月（4.6～18.5個月），3例（25%）發生并發癥，1例氣道腫瘤壞死物質多致氣促明顯加重，多次支氣管鏡清除后緩解，2例發生氣道狹窄，經多次球囊擴張治療，尚不影響日常生活。 結論 PDT治療中央氣道惡性腫瘤療效和安全性好，暫未發現嚴重并發癥。

[關鍵詞] 中央氣道惡性腫瘤;氣道狹窄;氣促;光動力治療

[中圖分類號] R735.05? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）25-0089-05

Observation on the effect of photodynamic therapy on malignant tumors of central airway

YANG Minyu? ?ZENG Junli? ?LIAO Junxiong? ?HUANG Rui

Respiratory Center，the Second Affiliated Hospital of Xiamen Medical College，Xiamen? ?361021，China

[Abstract] Objective To analyze the effectiveness and safety of photodynamic therapy （PDT） in central airway malignant tumors. Methods The clinical data of patients with central airway malignant tumors from October 2015 to October 2020 were retrospectively analyzed. The differences in airway stenosis and shortness of breath before and after PDT treatment were compared，and complications were observed. Results A total of 12 patients with central airway malignancies were collected， of whom two patients received 2 PDT， and the rest received 1 PDT. After 1 month of PDT treatment， airway stenosis decreased from 25% （25%， 75%） to 0 （0， 40%）， P=0.001， and the shortness of breath score decreased from 1 （0， 4） to 0 （0， 2） points， P=0.011. There were 2 cases of complete remission （16.7%）， 8 cases of partial remission （66.7%）， 1 case of stable disease （8.3%）， and 1 case of disease progression （8.3%）. All cases were followed up to February 28， 2021. The median follow-up time was 9.85 months （4.6-18.5 months）. Complications occurred in 3 cases （25%）. One patient with more airway tumor necrosis substances caused a significant increase in shortness of breath，which was relieved after repeated bronchoscopy. Airway stenosis occurred in 2 cases，which has not affected daily life after multiple balloon dilatation treatments. Conclusion PDT has good efficacy and safety in the treatment of central airway malignant tumors，and no serious complications have been found for the time being.

[Key words] Central airway malignant tumor; Airway stenosis; Shortness of breath; Photodynamic therapy