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一种用于早期头颈癌光动力治疗的新型光敏剂的治疗效果与组织浓度的关系

Therapeutic effects of a new photosensitizer for photodynamic therapy of early head and neck cancer in relation to tissue concentration.

作者信息

Yoshida Tomoyuki, Tokashiki Ryoji, Ito Hiroyuki, Shimizu Akira, Nakamura Kazuhiro, Hiramatsu Hiroyuki, Tsukahara Kiyoaki, Shimizu Shigetaka, Takata Daisuke, Okamoto Isaku, Suzuki Mamoru

机构信息

Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji city, Tokyo 193-0998, Japan.

出版信息

Auris Nasus Larynx. 2008 Dec;35(4):545-51. doi: 10.1016/j.anl.2007.10.008. Epub 2008 Feb 1.

Abstract

OBJECTIVE

Talaporfin sodium (Laserphyrin, Meiji Seika, Tokyo, Japan) is a second-generation photosensitizer developed in Japan. It is characterized by both mild and short-term skin photosensitivity. The objective of this study was to evaluate the efficacy and the pharmacokinetic characteristics in tumor tissues in patients with head and neck cancer.

METHODS

(1) Four hours after administration intravenous injection of talaporfin sodium (40 mg/m(2)), 100mg tissue specimens were taken from the central part of the tumor. The samples were analyzed by reverse phase liquid chromatography and concentrations were measured. (2) Four hours after intravenous injection of talaporfin sodium (40 mg/m(2)), we gave 60-150 J/cm(2) of 664 nm laser irradiation with a diode laser (PD laser, Panasonic, Japan). Biopsies were performed at 4 weeks and at 3 months after treatment and periodically thereafter to confirm the treatment efficacy of photodynamic therapy (PDT).

RESULTS

Of the 14 patients who grope informed consent, more than 1 microg/g of talaporfin sodium was found in the tumor tissues in 13. Moreover, in 9 patients, tumor-to-normal-tissue ratios ranged from 2.32:1 to 5.69:1, which indicates that more than double the amount of talaporfin sodium was maintained within the tumor than in normal tissues. We have enrolled 22 patients with head and neck cancer with no clinically recognizable metastases after obtaining written informed consent to participate in this study. PDT using talaporfin sodium exhibited the equivalent efficacy to that of conventional PDT using hematoporphyrin derivative (HpD).

CONCLUSIONS

The results using a combination of talaporfin sodium and PD laser achieved a primary treatment outcome equivalent to that of conventional PDT. This method has also proven to be advantageous because of the reduced incidence of side effects such as photosensitivity and local edema.

摘要

目的

替莫泊芬钠(Laserphyrin,日本明治制果株式会社,东京)是日本研发的第二代光敏剂。其特点是皮肤光敏反应轻微且持续时间短。本研究的目的是评估其对头颈部癌患者肿瘤组织的疗效及药代动力学特征。

方法

(1)静脉注射替莫泊芬钠(40mg/m²)4小时后,从肿瘤中央部位采集100mg组织标本。采用反相液相色谱法进行分析并测定浓度。(2)静脉注射替莫泊芬钠(40mg/m²)4小时后,使用二极管激光(PD激光,日本松下)给予664nm激光照射,剂量为60 - 150J/cm²。在治疗后4周、3个月及之后定期进行活检,以确认光动力疗法(PDT)的治疗效果。

结果

在14例签署知情同意书的患者中,13例肿瘤组织中替莫泊芬钠含量超过1μg/g。此外,9例患者的肿瘤组织与正常组织的比值在2.32:1至5.69:1之间,这表明肿瘤组织中替莫泊芬钠的含量比正常组织多一倍以上。在获得书面知情同意后,我们招募了22例无可临床识别转移灶的头颈部癌患者参与本研究。使用替莫泊芬钠的PDT与使用血卟啉衍生物(HpD)的传统PDT疗效相当。

结论

替莫泊芬钠与PD激光联合使用的结果达到了与传统PDT相当的主要治疗效果。该方法还被证明具有优势,因为光敏反应和局部水肿等副作用的发生率降低。

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