Jocham D, Baumgartner R, Stepp H, Unsöld E
Urologische Klinik und Poliklinik, Ludwig-Maximilians-Universität München, F.R.G.
J Photochem Photobiol B. 1990 Jun;6(1-2):183-7. doi: 10.1016/1011-1344(90)85088-e.
Photodynamic therapy (PDT) was given to 20 patients who had recurring superficial tumours after unsuccessful application of other treatments. The phototherapeutic results were evaluated by check-ups at 3 month intervals (endoscopy, cytology, bladder mapping, renal ultrasonography) and computed tomography (CT) examination at 8-13 month intervals. In six patients treated with PDT no tumour recurrence was found over the whole observation period up to nearly 5 years. Four patients remained free of tumour (12 and 14 months) after repeated transurethral resection (TUR) and Nd:YAG laser therapy following PDT. Due to an initial application of insufficient irradiation, four patients required a second photodynamic treatment. In one of these cases a circumscribed dysplasia which appeared at the left ostium 26 months following PDT was treated successfully using the Nd:YAG laser following TUR. In six patients slight mucosal atypia persisted for a period of at least 2.5 years. One cystectomy had to be performed because of bladder shrinkage. The dissected bladder was free of tumour. According to these preliminary results, PDT with strict patient selection (worst case situation with recommended cystectomy) is justified in the case of recurrent superficial TIS bladder carcinoma.
对20例经其他治疗失败后出现复发性浅表肿瘤的患者进行了光动力疗法（PDT）。通过每3个月进行一次检查（内镜检查、细胞学检查、膀胱造影、肾脏超声检查）以及每8 - 13个月进行一次计算机断层扫描（CT）检查来评估光疗效果。在接受PDT治疗的6例患者中，在长达近5年的整个观察期内均未发现肿瘤复发。4例患者在PDT后接受重复经尿道切除术（TUR）和钕钇铝石榴石（Nd:YAG）激光治疗后，肿瘤未复发（分别为12个月和14个月）。由于最初照射剂量不足，4例患者需要进行第二次光动力治疗。其中1例患者在PDT后26个月时，在左侧开口处出现局限性发育异常，在TUR后使用Nd:YAG激光成功治疗。6例患者的轻微黏膜异型性持续至少2.5年。因膀胱萎缩不得不进行1例膀胱切除术。切除的膀胱未发现肿瘤。根据这些初步结果，对于复发性浅表性Tis膀胱癌，在严格选择患者（推荐膀胱切除术的最坏情况）的情况下，PDT是合理的。
