Baron Elma D, Malbasa Christi L, Santo-Domingo Diana, Fu Pingfu, Miller Janine D, Hanneman Kaija K, Hsia Andrew H, Oleinick Nancy L, Colussi Valdir C, Cooper Kevin D
Department of Dermatology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio 44106, USA.
Lasers Surg Med. 2010 Dec;42(10):728-35. doi: 10.1002/lsm.20984.
Photodynamic therapy (PDT) is a non-invasive treatment for non-melanoma skin cancer. However, PDT systems currently used clinically have limitations such as pain and superficial tissue penetration. The silicon phthalocyanine Pc 4 is a second-generation photosensitizer with peak absorption in the far red at 675 nm.
To assess the safety and tolerability of topically applied Pc 4 followed by red light (Pc 4-PDT) in treating cutaneous neoplasms.
STUDY DESIGN/MATERIALS AND METHODS: Forty three adults with a diagnosis of neoplasms including actinic keratoses, Bowen's disease, squamous cell carcinoma, basal cell carcinoma, or mycosis fungoides were treated with a single administration of Pc 4-PDT and followed for 14 days. The study utilized a light and Pc 4 dose escalation design in sequential groups of three subjects each.
Pc 4-PDT was well tolerated with no significant local toxicity or increased photosensitivity. It has promising biologic effects, particularly in mycosis fungoides where 14 of 35 subjects demonstrated a clinical response, which correlates with Pc 4-PDT-induced apoptosis, as measured by increased active caspase-3 in the treated skin lesions.
Pc 4-PDT is a safe and tolerable treatment modality that effectively triggers apoptosis in cutaneous neoplasms such as mycosis fungoides.
光动力疗法（PDT）是一种用于治疗非黑色素瘤皮肤癌的非侵入性疗法。然而，目前临床上使用的PDT系统存在诸如疼痛和组织穿透浅等局限性。硅酞菁Pc 4是一种第二代光敏剂，在675nm的远红光处有峰值吸收。
评估局部应用Pc 4后再进行红光照射（Pc 4-PDT）治疗皮肤肿瘤的安全性和耐受性。
研究设计/材料与方法：43名被诊断患有包括光化性角化病、鲍恩病、鳞状细胞癌、基底细胞癌或蕈样肉芽肿在内的肿瘤的成年人接受了单次Pc 4-PDT治疗，并随访14天。该研究采用了光和Pc 4剂量递增设计，每组三名受试者，依次进行。
Pc 4-PDT耐受性良好，无明显局部毒性或光敏性增加。它具有有前景的生物学效应，特别是在蕈样肉芽肿中，35名受试者中有14名表现出临床反应，这与Pc 4-PDT诱导的细胞凋亡相关，通过治疗的皮肤病变中活性半胱天冬酶-3的增加来衡量。
Pc 4-PDT是一种安全且耐受性良好的治疗方式，可有效触发皮肤肿瘤如蕈样肉芽肿中的细胞凋亡。
