Kato H, Kito T, Furuse K, Sakai E, Ito K, Mimura S, Okusima N, Naito K, Suzuki S
Dept. of Surgery, Tokyo Medical College.
Gan To Kagaku Ryoho. 1990 Sep;17(9):1833-8.
The clinical application of photodynamic therapy (PDT) began in the late 1970's. Hematoporphyrin derivative has been used as a photosensitizer and recently Photofrin II (Dihematoporphyrin ether, DHE) was also developed as a second generation photosensitizer. The argon dye laseris used to excite the photosensitizer, however an eximer dye laser was recently developed as more effective laser. In a multicenter research study project team (7 institutions) on photodynamic therapy organized by the Ministry of Health and Welfare, 133 cases of gastric cancer (including 120 cases of early stage cancer), 209 cases of lung cancer (69 cases of early stage cancer), 66 cases of esophageal cancer (22 cases of early stage cancer), 68 cases of bladder cancer (68 cases of early stage cancer), and 86 cases of other organ cancers were treated. In early stage cancer cases 77.3% showed complete remission (CR) but among those the recurrence was 15.7% in lung cancer cases and opposed to 100% CR and 22.2% recurrence in gastric cancer cases, 80% CR and no recurrence in esophageal cancer cases, and 68.6% CR and 58.3% recurrence in bladder cancer cases. Especially in limited lesions less than 1 cm in diameter, the CR was obtained in 100% and the recurrence was recognized in only 1 (2.6%) of 28 lung cancer lesions, 100% CR and no recurrence was obtained in 30 lesions of gastric cancer and also 100% CR with no recurrence was recognized in 16 lesions in bladder cancer. This study suggests that PDT has the potential to cure early stage cancer lesions.
光动力疗法(PDT)的临床应用始于20世纪70年代末。血卟啉衍生物一直被用作光敏剂,最近,第二代光敏剂卟吩姆钠(双血卟啉醚,DHE)也已研发出来。氩染料激光用于激发光敏剂,不过最近研发出的准分子染料激光更为有效。在由厚生省组织的光动力疗法多中心研究项目团队(7个机构)中,对133例胃癌(包括120例早期癌症)、209例肺癌(69例早期癌症)、66例食管癌(22例早期癌症)、68例膀胱癌(68例早期癌症)以及86例其他器官癌症进行了治疗。在早期癌症病例中,77.3%显示完全缓解(CR),但其中肺癌病例的复发率为15.7%,与之相对的是,胃癌病例的完全缓解率为100%,复发率为22.2%;食管癌病例的完全缓解率为80%,无复发;膀胱癌病例的完全缓解率为68.6%,复发率为58.3%。特别是在直径小于1厘米的局限性病变中,28个肺癌病变中有1个(2.6%)实现了100%的完全缓解且仅1例复发,30个胃癌病变实现了100%的完全缓解且无复发,16个膀胱癌病变也实现了100%的完全缓解且无复发。这项研究表明,光动力疗法有治愈早期癌症病变的潜力。