UCL Institute for Liver and Digestive Health, University College London, UCL Medical School-Royal Free Hospital Campus, U3 Floor, Pond Street, London NW3 2QG, UK.
Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, USA.
Br J Cancer. 2014 Apr 2;110(7):1698-704. doi: 10.1038/bjc.2014.95. Epub 2014 Feb 25.
Patients with pancreatic cancer have a poor prognosis apart from the few suitable for surgery. Photodynamic therapy (PDT) produces localised tissue necrosis but previous studies using the photosensitiser meso-tetrahydroxyphenylchlorin (mTHPC) caused prolonged skin photosensitivity. This study assessed a shorter acting photosensitiser, verteporfin.
Fifteen inoperable patients with locally advanced cancers were sensitised with 0.4 mg kg(-1) verteporfin. After 60-90 min, laser light (690 nm) was delivered via single (13 patients) or multiple (2 patients) fibres positioned percutaneously under computed tomography (CT) guidance, the light dose escalating (initially 5 J, doubling after each three patients) until 12 mm of necrosis was achieved consistently.
In all, 12 mm lesions were seen consistently at 40 J, but with considerable variation in necrosis volume (mean volume 3.5 cm(3) at 40 J). Minor, self-limiting extrapancreatic effects were seen in multifibre patients. No adverse interactions were seen in patients given chemotherapy or radiotherapy before or after PDT. After PDT, one patient underwent an R0 Whipple's pancreaticoduodenectomy.
Verteporfin PDT-induced tumour necrosis in locally advanced pancreatic cancer is feasible and safe. It can be delivered with a much shorter drug light interval and with less photosensitivity than with older compounds.
除了少数适合手术的患者外，胰腺癌患者的预后较差。光动力疗法（PDT）可导致局部组织坏死，但以前使用光敏剂间四羟基苯基氯（mTHPC）的研究导致皮肤光敏性延长。本研究评估了一种作用时间更短的光敏剂——维替泊芬。
15 名局部晚期癌症无法手术的患者用 0.4mg/kg 的维替泊芬进行敏化。60-90 分钟后，通过 CT 引导下经皮单次（13 名患者）或多次（2 名患者）放置光纤输送激光光（690nm），光剂量逐渐增加（最初为 5J，每增加三个患者后增加一倍），直到达到 12mm 的一致坏死。
在所有患者中，40J 时均可见到 12mm 的病变，但坏死体积有很大差异（40J 时平均体积为 3.5cm3）。多光纤患者出现轻微的、自限性的胰外效应。在接受化疗或放疗前后接受 PDT 的患者中未观察到不良相互作用。PDT 后，一名患者接受了 R0 胰十二指肠切除术。
维替泊芬 PDT 诱导局部晚期胰腺癌肿瘤坏死是可行且安全的。与旧化合物相比，它可以在更短的药物光照间隔内给药，并且光敏性更低。
