Gahlen J, Prosst R L, Stern J
Chirurgische Universitätsklinik, Klinikum Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim.
Chirurg. 2002 Feb;73(2):122-31. doi: 10.1007/s00104-001-0371-7.
Photodynamic therapy (PDT) is characterized by the extensive selective accumulation of a photoactive agent, the photosensitizer, in malignant or precancerous tumour cells. The photoactive compound is activated by light beam of a specific wavelength and causes cell death. A significant proportion of patients with gastrointestinal malignancies cannot undergo curative treatment, as either the cancer is too advanced or the patient's general constitution is too poor to allow invasive strategies. In such cases, PDT has already proven to be a promising therapeutic modality for selected dysplasias and malignancies in the gastrointestinal tract.
A retrospective review of the literature was performed in order to determine the experience gained with PDT and to assess its clinical value in the curative and palliative management of gastrointestinal neoplasms.
PDT seems to be an adequate treatment for selected forms of early cancer and small lesions of the GI tract or for small residual areas after the tumour has been debulked by other techniques (e.g. limited surgical resection, thermal ablation). Especially for patients who refuse or are ineligible for conventional surgery, PDT offers promising results compared to currently accepted clinical approaches.
As a primary or adjuvant mode for either curative or palliative treatment of gastrointestinal neoplasms, PDT is a potentially effective, minimally invasive therapeutic modality. However, further clinical assessment by means of comparative, standardized studies is essential to the definition of its role in oncology.
光动力疗法（PDT）的特点是光活性剂（即光敏剂）在恶性或癌前肿瘤细胞中广泛选择性积聚。该光活性化合物由特定波长的光束激活并导致细胞死亡。相当一部分胃肠道恶性肿瘤患者无法接受根治性治疗，原因要么是癌症过于晚期，要么是患者的一般体质太差而无法采用侵入性治疗策略。在这种情况下，光动力疗法已被证明是治疗胃肠道特定发育异常和恶性肿瘤的一种有前景的治疗方式。
对文献进行回顾性研究，以确定光动力疗法的经验，并评估其在胃肠道肿瘤的根治性和姑息性治疗中的临床价值。
光动力疗法似乎是治疗胃肠道早期癌症特定类型、小病灶或肿瘤经其他技术（如有限手术切除、热消融）减瘤后小残留区域的一种合适治疗方法。特别是对于拒绝或不适合常规手术的患者，与目前公认的临床方法相比，光动力疗法能取得有前景的结果。
作为胃肠道肿瘤根治性或姑息性治疗的主要或辅助方式，光动力疗法是一种潜在有效的、微创的治疗方式。然而，通过比较性、标准化研究进行进一步临床评估对于确定其在肿瘤学中的作用至关重要。
