Usuda Jitsuo, Kato Harubumi, Okunaka Tetsuya, Furukawa Kinya, Tsutsui Hidemitsu, Yamada Kimito, Suga Yasuhiro, Honda Hidetoshi, Nagatsuka Yoshitaka, Ohira Tatsuo, Tsuboi Masahiro, Hirano Takashi
Department of Thoracic Surgery, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.
J Thorac Oncol. 2006 Jun;1(5):489-93.
Photodynamic therapy (PDT), a treatment for cancer, uses a photosensitizer and laser irradiation to produce reactive oxygen in cells. In Japan, the United States, and many other countries, PDT is a treatment option for stage 0 (TisN0M0) and stage I (T1N0M0) centrally located early stage lung cancer. PDT can preserve lung function, can be repeated, and can be combined with other therapeutic modalities such as chemotherapy. Recently, mono-l-aspartyl chlorine e6 (NPe6, Laserphyrin), a second-generation photosensitizer with lower photosensitivity than Photofrin (porfimer sodium), was approved by the Japanese government and a phase II clinical study using NPe6 with a new diode laser demonstrated an excellent antitumor effect and low skin photosensitivity. We expect PDT to be widely employed in many fields and the applications of PDT to be extended because of the decreasing cost of laser equipment and lower systemic photosensitivity induced by the photosensitizer. The purpose of this review is to introduce not only recent clinical trials of PDT for centrally located early lung cancer, but also new applications of PDT for cases of peripheral-type, early-stage lung cancers. We also discuss the applications of PDT for advanced lung cancer and combined therapy using PDT and other treatments for lung cancer.
光动力疗法(PDT)是一种癌症治疗方法,它利用光敏剂和激光照射在细胞中产生活性氧。在日本、美国和许多其他国家,PDT是0期(TisN0M0)和I期(T1N0M0)中央型早期肺癌的一种治疗选择。PDT可以保留肺功能,可以重复进行,并且可以与化疗等其他治疗方式联合使用。最近,单-L-天冬氨酸氯e6(NPe6,Laserphyrin),一种比Photofrin(卟吩姆钠)光敏性更低的第二代光敏剂,获得了日本政府的批准,一项使用NPe6与新型二极管激光的II期临床研究显示出优异的抗肿瘤效果和较低的皮肤光敏性。由于激光设备成本的降低以及光敏剂引起的全身光敏性降低,我们预计PDT将在许多领域得到广泛应用,并且PDT的应用范围将得到扩展。本综述的目的不仅是介绍最近针对中央型早期肺癌的PDT临床试验,还介绍PDT在外周型早期肺癌病例中的新应用。我们还讨论了PDT在晚期肺癌中的应用以及使用PDT和其他肺癌治疗方法的联合治疗。