Wang Yu, Lin Yong, Zhang Hui-guo, Zhu Jing
Department of Neurological Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, People's Republic of China.
Department of Dermatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, People's Republic of China.
J Cancer Res Clin Oncol. 2016 Apr;142(4):813-21. doi: 10.1007/s00432-015-2066-3. Epub 2015 Nov 18.
Although photodynamic therapy (PDT) has been shown to be effective in cancer treatment, its side effects, such as a long-lasting skin photosensitivity after the application, still cause patient's inconvenience. In this retrospective cohort study, our objective was to explore a more efficient but less phototoxic PDT for skin cancers.
The PDT combined with a topical photosensitizer 5-aminolevulinic acid (ALA) and an intravenously injected light-sensitive agent hematoporphyrin derivative (HPD) was used to treat 26 patients with 41 skin cancer lesions in head and face. The findings were then compared with the results of the HPD-PDT alone and the ALA-PDT following CO2 laser ablation on 28 and 41 skin cancer patients, respectively.
The complete remission rate for the combined PDT was 100 % in 2 months and 97.6 % in a 6 months to 6 years trial after the treatment compared with those of 92.9 and 95.1 % for the HPD-PDT and the ALA-PDT after a single treatment, respectively. Moreover, while the patient treated with the HPD-PDT needs to avoid strong light exposure for 4-5 weeks, the combined PDT significantly reduced the period to 10-14 days. Also, in the combined PDT, the dose of the HPD, a pro-toxic light-sensitive drug, was much lower than that in the HPD-PDT.
The combined PDT not only shows high cure rate for skin cancers but also decreases the dose of the pro-toxic HPD and significantly shortens the photosensitive period, from which the patients are able to benefit.
尽管光动力疗法(PDT)已被证明在癌症治疗中有效,但其副作用,如治疗后长期的皮肤光敏感性,仍然给患者带来不便。在这项回顾性队列研究中,我们的目标是探索一种对皮肤癌更有效但光毒性更小的光动力疗法。
使用光动力疗法联合外用光敏剂5-氨基乙酰丙酸(ALA)和静脉注射光敏剂血卟啉衍生物(HPD)治疗26例头面部皮肤癌患者的41个病灶。然后将结果分别与单独使用HPD-PDT以及对28例和41例皮肤癌患者进行二氧化碳激光消融后使用ALA-PDT的结果进行比较。
联合光动力疗法在治疗后2个月的完全缓解率为100%,在6个月至6年的试验中为97.6%,而单次治疗后HPD-PDT和ALA-PDT的完全缓解率分别为92.9%和95.1%。此外,接受HPD-PDT治疗的患者需要避免强光照射4-5周,而联合光动力疗法显著将这一时期缩短至10-14天。而且,在联合光动力疗法中,作为潜在毒性光敏药物的HPD剂量远低于HPD-PDT中的剂量。
联合光动力疗法不仅对皮肤癌显示出高治愈率,而且降低了潜在毒性HPD的剂量,并显著缩短了光敏期,患者能够从中受益。