拉达霉素光动力疗法治疗晚期非小细胞肺癌的疗效：一项初步研究。

The effect of Radachlorin® PDT in advanced NSCLC: a pilot study.

机构信息

Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.

出版信息

Photodiagnosis Photodyn Ther. 2013 May;10(2):120-6. doi: 10.1016/j.pdpdt.2013.01.004. Epub 2013 Mar 16.

DOI:10.1016/j.pdpdt.2013.01.004

PMID:23769277

Abstract

BACKGROUND

Palliative effect of PDT in advanced NSCLC has been proven. Radachlorin® is a second generation photosensitizer that has quicker pharmacokinetics than first generation photosensitizers. Although there are reports describing Radachlorin®, limited data are available regarding its advantages in PDT.

METHODS

Advanced NSCLC patients with central airway obstruction were enrolled. Patients who had comorbidity effects on drug metabolism were excluded. All patients received 1mg/kg of Radachlorin®, 4 h before light irradiation. 200 J/cm² of laser was irradiated during 11 min 6 s. Bronchial toileting was performed the following day. A PFT was performed before and after PDT. The primary treatment outcome was improvement of airway obstruction, which was evaluated according to bronchoscopic findings and improvement of FEV1. Secondary treatment outcomes included the rate of PDT-related complications, one year survival rate and progression free survival.

RESULTS

Ten patients were enrolled between June 2010 and May 2011. Their median age was 58.5 years and their baseline cancer stage was more than IIIA. 20% of patients showed successful results, 70% showed partially successful results and 10% showed an unsuccessful result. All patients showed improvement in their obstructive symptoms. The mean FEV1 before PDT was 1.70±0.69 L, while the mean FEV1 after PDT was 1.99±0.60 L (P=0.029). No patients had major complications. Eight patients were undergoing additional treatment after resolving airway obstruction. The one year survival rate after PDT was 70%.

CONCLUSIONS

Radachlorin®-based PDT is safe and effective treatment for relieving central airway obstruction in advanced NSCLC.

摘要

背景

PDT 在晚期 NSCLC 中的姑息治疗效果已得到证实。拉达氯林®是第二代光敏剂，其药代动力学比第一代光敏剂更快。虽然有描述拉达氯林®的报告，但关于其在 PDT 中的优势的数据有限。

方法

招募了患有中央气道阻塞的晚期 NSCLC 患者。排除了对药物代谢有合并症影响的患者。所有患者在光照前 4 小时接受 1mg/kg 的拉达氯林®。在 11 分 6 秒内照射 200 J/cm²的激光。第二天进行支气管灌洗。在 PDT 前后进行 PFT。主要治疗结果是气道阻塞的改善，根据支气管镜检查结果和 FEV1 的改善来评估。次要治疗结果包括 PDT 相关并发症的发生率、一年生存率和无进展生存率。

结果

2010 年 6 月至 2011 年 5 月期间招募了 10 名患者。他们的中位年龄为 58.5 岁，基线期癌症分期为 IIIA 期以上。20%的患者取得了成功结果，70%的患者取得了部分成功结果，10%的患者取得了不成功结果。所有患者的阻塞症状均有所改善。 PDT 前的平均 FEV1 为 1.70±0.69 L，而 PDT 后的平均 FEV1 为 1.99±0.60 L（P=0.029）。无患者发生重大并发症。气道阻塞缓解后，有 8 名患者正在接受额外治疗。 PDT 后的一年生存率为 70%。