光动力治疗中央气道恶性肿瘤的疗效观察

杨敏玉 曾俊莉 廖俊雄 黄锐

[摘要] 目的 分析光動力治疗（PDT）在中央气道恶性肿瘤的有效性和安全性。 方法 回顾性分析2015年10月至2020年10月中央气道恶性肿瘤患者的临床资料，对比PDT治疗前后气道狭窄、气促等的差异，并观察并发症。结果 共收集中央气道恶性肿瘤患者12例，其中2例患者接受2次PDT，其余患者均接受1次PDT。PDT治疗1个月后，气道狭窄由25%（25%，75%）下降至0（0，40%），P=0.001，气促评分由1（0，4）分下降至 0（0，2）分，P=0.011，完全缓解2例（16.7%）、部分缓解8例（66.7%）、疾病稳定1例（8.3%）、疾病进展1例（8.3%）。所有病例随访至2021年2月28日，中位随访时间为9.85个月（4.6～18.5个月），3例（25%）发生并发症，1例气道肿瘤坏死物质多致气促明显加重，多次支气管镜清除后缓解，2例发生气道狭窄，经多次球囊扩张治疗，尚不影响日常生活。 结论 PDT治疗中央气道恶性肿瘤疗效和安全性好，暂未发现严重并发症。

[关键词] 中央气道恶性肿瘤;气道狭窄;气促;光动力治疗

[中图分类号] R735.05          [文献标识码] B          [文章编号] 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