Muroya T, Kawasaki K, Suehiro Y, Kunugi T, Umayahara K, Akiya T, Iwabuchi H, Sakunaga H, Sakamoto M, Sugishita T, Tenjin Y
Department of Gynecology Sasaki Institute Kyoundo Hospital 1-8 Kanda, Surugadai, Chiyoda-ku Tokyo 101-0062 Japan.
Diagn Ther Endosc. 1999;5(3):183-90. doi: 10.1155/DTE.5.183.
We have been performing PDT using Excimer Dye Laser (EDL) or YAG-OPO laser, a type of low power laser, both of which have a considerably higher degree of tissue penetration even when compared to PDT using Argon Dye Laser (ADL).PDT is a relatively simple procedure without any bleeding and does not require anesthesia since it causes no pain. PDT is performed 48 h after intravenous injection of 1.5-2.0 mg/kg of PHE (Photofrin((R))). Precise spot irradiation is possible using a colposcope with an optical laser path. We also use a cervical probe which enables photoirradiation of the entire cervical canal.We have performed PDT on 131 cases (95 CIS, 31 dysplasia, 1 vulval dysplasia (VIN), 3 squamous cell carcinoma, microinvasion, and 1 CIS + endocervical adenocarcinoma, microinvasion). Of these cases, 127 became CR (96.9%). The first CR case was 10 years ago and no recurrence has been observed yet.PDT is extremely effective to preserve fertility. Except for sensitive reactions to sunlight, there are no noticeable side effects or difficulties related to pregnancy or delivery. We expect that in the near future PDT will be performed using diode lasers and without hospitalization due to new photosensitizers which have shorter retention times.
我们一直在使用准分子染料激光（EDL）或YAG-OPO激光进行光动力疗法（PDT），这是一种低功率激光，与使用氩染料激光（ADL）进行的PDT相比，二者都具有更高的组织穿透程度。PDT是一种相对简单的操作，不会出血，且由于不引起疼痛所以不需要麻醉。在静脉注射1.5 - 2.0mg/kg的PHE（光敏剂（商品名Photofrin((R))））后48小时进行PDT。使用带有光学激光路径的阴道镜可以进行精确的点状照射。我们还使用一种宫颈探头，能够对整个宫颈管进行光照射。我们已对131例患者进行了PDT（95例原位癌、31例发育异常、1例外阴发育异常（VIN）、3例微浸润鳞状细胞癌以及1例原位癌 + 宫颈管腺癌微浸润）。在这些病例中，127例达到完全缓解（CR，96.9%）。首例CR病例发生在10年前，至今未观察到复发。PDT在保留生育能力方面极其有效。除了对阳光敏感反应外，没有明显的副作用，也没有与妊娠或分娩相关的困难。我们预计在不久的将来，由于新的光敏剂具有更短的滞留时间，将使用二极管激光进行PDT且无需住院。
