Usuda Jitsuo, Tsutsui Hidemitsu, Honda Hidetoshi, Ichinose Shuji, Ishizumi Taichirou, Hirata Takeshi, Inoue Tatsuya, Ohtani Keishi, Maehara Sachio, Imai Kentarou, Tsunoda Yoshihiko, Kubota Mitsuhiro, Ikeda Norihiko, Furukawa Kinya, Okunaka Tetsuya, Kato Harubumi
Department of Thoracic Surgery, Tokyo Medical University Hospital, Tokyo 160-0023, Japan.
Lung Cancer. 2007 Dec;58(3):317-23. doi: 10.1016/j.lungcan.2007.06.026. Epub 2007 Aug 15.
We had previously developed the possibility of use of a photodynamic diagnosis (PDD) system using a tumor-selective photosensitizer and laser irradiation for the early detection and photodynamic therapy (PDT) for centrally located early lung cancers. Recently, we established the autofluorescence diagnosis system integrated into a videoendoscope (SAFE-3000) as a very useful technique for the early diagnosis of lung cancer.
Twenty-nine patients (38 lesions) with centrally located early lung cancer received PDD and PDT using the second-generation photosensitizer, talaporfin sodium (NPe6). Just before the PDT, we defined the tumor margin accurately using the novel PDD system SAFE-3000 with NPe6 and a diode laser (408nm).
Red fluorescence emitted from the tumor by excitation of the photosensitizer by the diode laser (408nm) from SAFE-3000 allowed accurate determination of the tumor margin just before the PDT. The complete remission (CR) rate following NPe6-PDT in the cases with early lung cancer was 92.1% (35/38 lesions). We also confirmed the loss of red fluorescence from the tumors immediately after the PDT using SAFE-3000. We confirmed that all the NPe6 in the tumor had been excited and photobleached by the laser irradiation (664nm) and that no additional laser irradiation was needed for curative treatment.
This novel PDD system using SAFE-3000 and NPe6 improved the quality and efficacy of PDT and avoided misjudgement of the dose of the photosensitizer or laser irradiation in PDT. PDT using NPe6 will become a standard option of treatments for centrally located early lung cancer.
我们之前已经开发出一种光动力诊断（PDD）系统，该系统使用肿瘤选择性光敏剂和激光照射，用于早期检测和对位于中央的早期肺癌进行光动力治疗（PDT）。最近，我们建立了一种集成在视频内窥镜中的自体荧光诊断系统（SAFE - 3000），作为肺癌早期诊断的一种非常有用的技术。
29例（38个病灶）位于中央的早期肺癌患者接受了使用第二代光敏剂替拉泊芬钠（NPe6）的PDD和PDT。在PDT之前，我们使用新型PDD系统SAFE - 3000结合NPe6和二极管激光（408nm）准确界定了肿瘤边界。
SAFE - 3000发出的二极管激光（408nm）激发光敏剂后，肿瘤发出的红色荧光使得在PDT之前能够准确确定肿瘤边界。早期肺癌病例中NPe6 - PDT后的完全缓解（CR）率为92.1%（35/38个病灶）。我们还使用SAFE - 3000证实了PDT后肿瘤立即失去红色荧光。我们确认肿瘤中的所有NPe6都已被激光照射（664nm）激发并光漂白，并且治愈性治疗无需额外的激光照射。
这种使用SAFE - 3000和NPe6的新型PDD系统提高了PDT的质量和疗效，避免了在PDT中对光敏剂剂量或激光照射的误判。使用NPe6的PDT将成为位于中央的早期肺癌治疗的标准选择。
