Clinical Photobiology, European Centre for Environment and Human Health, Peninsula Medical School, University of Exeter, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, UK.
J Photochem Photobiol B. 2011 Apr 4;103(1):1-7. doi: 10.1016/j.jphotobiol.2010.12.011. Epub 2010 Dec 28.
Methyl aminolevulinate photodynamic therapy (MAL-PDT) is utilized to successfully treat licensed indications (e.g. actinic keratosis (AK), superficial basal cell carcinoma (sBCC) and Bowen's disease (BD)) in the UK. Air cooling devices (ACD) are commonly utilized as a method of pain relief, however the effect of this on treatment outcome has never been extensively investigated. This non-randomized, retrospective observational controlled study investigated whether the application of the ACD limited photosensitiser (protoporphyrin IX - PpIX) photobleaching during irradiation and/or subsequent clinical outcome. Patients utilizing the ACD throughout treatment were observed to undergo significantly less PpIX photobleaching than the control group (P<0.001) and complete clinical clearances observed at 3 months were also reduced within the ACD group. Separate analysis of the different lesion types indicated that significantly less photobleaching occurred in AK lesions with ACD and all lesion types failed to fully utilize the accumulated PpIX when ACD was employed. The application of the ACD as pain relief during light irradiation therefore resulted in lower PpIX photobleaching which corresponded to a reduction in the efficacy of PDT treatment. Whilst the ACD is an effective method of dermatological PDT analgesia it should be utilized as sparingly as possible to minimize any deleterious effects on treatment outcome.
甲氨基酮戊酸光动力疗法 (MAL-PDT) 在英国被用于成功治疗有适应证的疾病（如光化性角化病 (AK)、浅表基底细胞癌 (sBCC) 和 Bowen 病 (BD)）。空气冷却设备 (ACD) 通常被用作缓解疼痛的方法，但其对治疗效果的影响从未被广泛研究过。这项非随机、回顾性观察性对照研究调查了 ACD 的应用是否限制了照射期间的光敏剂（原卟啉 IX - PpIX）光漂白和/或随后的临床结果。观察到在整个治疗过程中使用 ACD 的患者经历的 PpIX 光漂白明显少于对照组（P<0.001），并且在 ACD 组中，也降低了 3 个月时完全临床清除的发生率。对不同病变类型的单独分析表明，在 AK 病变中，ACD 下发生的光漂白明显减少，当使用 ACD 时，所有病变类型都未能充分利用积累的 PpIX。因此，在光照射期间使用 ACD 缓解疼痛会导致 PpIX 光漂白减少，这对应于 PDT 治疗效果的降低。尽管 ACD 是一种有效的皮肤科 PDT 镇痛方法，但应尽可能少地使用它，以尽量减少对治疗效果的任何有害影响。
