中国内镜杂志2025，Vol.31Issue(7)：11-18,8.DOI:10.12235/E20240612
内镜射频消融术与光动力疗法治疗不可切除肝外胆管癌远期疗效的对比研究
Long-term efficacy study of endoscopic radiofrequency ablation and photodynamic therapy for unresectable extrahepatic cholangiocarcinoma
张洪战 1张明 1庄东海 1安伟 1孙斌 1丁辉 1张锎1
作者信息
- 1. 山东大学附属山东省立第三医院 肝胆外科,山东 济南 250031
- 折叠
摘要
Abstract
Objective To evaluate and compare the long-term efficacy of endoscopic radiofrequency ablation(RFA)and photodynamic therapy(PDT)combined with biliary stenting for the treatment of unresectable extrahepatic cholangiocarcinoma.Methods Clinical data of patients with cholangiocarcinoma who received endoscopic RFA or PDT treatment from February 2018 to February 2023 were retrospectively collected.The patients were divided into RFA group(n=30,received endoscopic RFA combined with biliary stent placement)and PDT group(n=20,received PDT combined with biliary stent placement).The frequency of treatment,stent patency time,overall survival time and adverse events incidence were counted.The factors affecting the survival time of patients were analyzed.Results The overall survival time was 14.0(95%CI:11.8～16.2)months in RFA group and 18.0(95%CI:15.4～20.6)months in PDT group,the median patency time of stent was 4.0(95%CI:2.7～5.3)months in RFA group and 3.5(95%CI:2.3～4.7)months in PDT group,the differences were not statistically significant(P>0.05).Multivariate Cox regression analysis showed that the H＾R of patients with≥2 endoscopic RFA or PDT treatments was 2.417,which was a protective factor affecting overall survival(P=0.018),while the H＾R of TNM stage Ⅲ to Ⅳ was 0.300,which was a risk factor affecting the overall survival period(P=0.002).No significant difference was found in clinical success rate(both 100.00%)and adverse events incidence between the two groups[28.13%(9/32)vs.23.81%(5/21)],the difference was not statistically significant(P>0.05).Conclusion The long-term efficacy of endoscopic RFA or PDT combined with biliary stenting in the treatment of unresectable extrahepatic cholangiocarcinoma is comparable,while the sequential treatment of endoscopic RFA or PDT≥2 times can effectively prolong the overall survival of patients.关键词
内镜射频消融术(RFA)/光动力疗法(PDT)/胆管癌/生存期/远期疗效/内镜逆行胰胆管造影术(ERCP)Key words
endoscopic radiofrequency ablation(RFA)/photodynamic therapy(PDT)/cholangiocarcinoma/survival time/long-term efficacy/endoscopic retrograde cholangiopancreatography(ERCP)分类
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张洪战,张明,庄东海,安伟,孙斌,丁辉,张锎..内镜射频消融术与光动力疗法治疗不可切除肝外胆管癌远期疗效的对比研究[J].中国内镜杂志,2025,31(7):11-18,8.
