Harty J I, Amin M, Wieman T J, Tseng M T, Ackerman D, Broghamer W
Department of Surgery, University of Louisville School of Medicine, Kentucky.
J Urol. 1989 Jun;141(6):1341-6. doi: 10.1016/s0022-5347(17)41302-4.
Photodynamic therapy with dihematoporphyrin ether was used to treat superficial bladder tumors in 7 patients with a followup of at least 1 year. Each patient received treatment to the whole bladder and those with papillary lesions received additional focal treatment. At 3 months 4 of the 5 patients with papillary tumors (stages Ta and T1) and 1 of the 2 with diffuse carcinoma in situ (Tis) were free of disease. However, at 1 year only 3 patients remained free of disease. Of 5 patients with an increase in irritative bladder symptoms 4 had a contracted bladder, hydroureteronephrosis and vesicoureteral reflux. Deep bladder biopsies showed replacement of smooth muscle by fibrous tissue. Six patients had mild to moderate skin phototoxicity. We conclude that although photodynamic therapy is an attractive and exciting method to treat cancer, its use with dihematoporphyrin ether in cases of bladder carcinoma can be associated with significant complications. The correct treatment parameters for safe, effective therapy are not known to date.
使用二血卟啉醚进行光动力疗法治疗7例浅表性膀胱肿瘤患者，随访至少1年。每位患者均接受全膀胱治疗，有乳头状病变的患者还接受了额外的局部治疗。3个月时，5例乳头状肿瘤（Ta期和T1期）患者中有4例以及2例原位弥漫性癌（Tis）患者中有1例无疾病。然而，1年后只有3例患者仍无疾病。5例膀胱刺激症状加重的患者中，4例出现膀胱挛缩、肾盂积水和膀胱输尿管反流。膀胱深层活检显示平滑肌被纤维组织替代。6例患者有轻度至中度皮肤光毒性。我们得出结论，尽管光动力疗法是一种治疗癌症的有吸引力且令人兴奋的方法，但其在膀胱癌病例中与二血卟啉醚联合使用可能会伴有严重并发症。迄今为止，尚不清楚安全、有效治疗的正确治疗参数。
