Yu Guoqiang, Durduran Turgut, Zhou Chao, Zhu Timothy C, Finlay Jarod C, Busch Theresa M, Malkowicz S Bruce, Hahn Stephen M, Yodh Arjun G
Department of Physics & Astronomy, University of Pennsylvania, Philadelphia, PA, USA.
Photochem Photobiol. 2006 Sep-Oct;82(5):1279-84. doi: 10.1562/2005-10-19-RA-721.
Photodynamic therapy (PDT) requires oxygen to cause cellular and vascular tumor damage. Tissue oxygen concentration, in turn, is influenced by blood flow and blood oxygenation. Real-time clinical measurement of these hemodynamic quantities, however, is rare. This paper reports the development and application of a probe, combining diffuse reflectance spectroscopy (DRS) for measurement of tumor blood oxygenation and diffuse correlation spectroscopy (DCS) for measurement of tumor blood flow. The instrument was adapted for clinical use during interstitial prostate PDT. Three patients with locally recurrent prostate cancer received 2 mg/ kg motexafin lutetium (MLu) 3 h before illumination and a total light dose of 100 J/cm(2) at 150 mW/cm. Prostrate blood oxygen saturation (StO2) decreased only slightly (approximately 3%) after treatment. On the other hand, prostate blood flow and total hemoglobin concentration over the course of PDT decreased by 50% and 15%, respectively, suggesting MLu-mediated PDT has an anti-vascular effect. While it is certainly impossible to draw definite conclusions from measurements of only three patients, the observed differences in tumor blood flow and blood oxygenation responses during PDT can, in principle, be used to choose among tissue oxygen consumption models and therefore emphasize the potential clinical value for simultaneous monitoring of both parameters.
光动力疗法（PDT）需要氧气来造成细胞和血管肿瘤损伤。而组织氧浓度又受血流和血液氧合作用的影响。然而，这些血流动力学参数的实时临床测量却很少见。本文报道了一种探头的研发与应用，该探头结合了用于测量肿瘤血液氧合的漫反射光谱法（DRS）和用于测量肿瘤血流的扩散相关光谱法（DCS）。该仪器适用于间质前列腺光动力疗法的临床应用。三名局部复发性前列腺癌患者在光照前3小时接受2mg/kg的莫特沙芬镥（MLu），并在150mW/cm²的条件下接受100J/cm²的总光剂量。治疗后前列腺血氧饱和度（StO2）仅略有下降（约3%）。另一方面，在光动力疗法过程中，前列腺血流和总血红蛋白浓度分别下降了50%和15%，这表明MLu介导的光动力疗法具有抗血管作用。虽然仅通过三名患者的测量结果肯定无法得出明确结论，但在光动力疗法期间观察到的肿瘤血流和血液氧合反应差异原则上可用于在组织氧消耗模型中进行选择，因此强调了同时监测这两个参数的潜在临床价值。
