Cengel Keith A, Simone Charles B, Glatstein Eli
University of Pennsylvania, Philadelphia, Pennsylvania.
Cancer Res. 2016 May 1;76(9):2497-9. doi: 10.1158/0008-5472.CAN-16-0927.
Despite descriptions of light-mediated therapy in ancient texts and the discovery of photodynamic therapy (PDT) in the early 1900s, the landmark article in 1978 in Cancer Research by Dougherty and his colleagues at the Roswell Park Cancer Institute remains rightly viewed as the starting point for clinical PDT in modern medicine. As a large clinical series that explored many of the factors now viewed as critical determinates of PDT dose, efficacy, and toxicity, that study showed remarkable foresight, yet it also served to raise as many questions as it answered. Since its publication, PDT has been increasingly utilized in clinical practice for the treatment of both benign and malignant conditions, and many of their questions have yielded new technologies and areas of investigation, thus remaining highly relevant nearly 40 years after their initial asking. Moreover, continuing advances in our ability to measure physical properties such as absorbed light dose, photosensitizer concentration, tissue oxygen concentration, and singlet oxygen production in real-time may allow for adaptive modification of light delivery during PDT on a fine scale to optimize treatment response. Finally, combining molecularly targeted drugs and novel photosensitizers has the potential to improve further the therapeutic index and extend the spectrum of clinical PDT far beyond what was imagined when that sentinel manuscript was written. Cancer Res; 76(9); 2497-9. ©2016 AACRSee related article by Dougherty et al., Cancer Res 1978;38:2628-35Visit the Cancer Research 75(th) Anniversary timeline.
尽管古代文献中就有光介导疗法的描述,且在20世纪初发现了光动力疗法(PDT),但1978年罗斯韦尔帕克癌症研究所的多尔蒂及其同事发表在《癌症研究》上的具有里程碑意义的文章,仍被公认为现代医学中临床PDT的起点。作为一个大型临床系列研究,该研究探讨了许多如今被视为PDT剂量、疗效和毒性关键决定因素的因素,显示出了非凡的前瞻性,但它也提出了与解答的问题一样多的疑问。自发表以来,PDT在临床实践中越来越多地用于治疗良性和恶性疾病,其中许多问题催生了新技术和研究领域,因此在最初提出近40年后仍具有高度相关性。此外,我们实时测量诸如吸收光剂量、光敏剂浓度、组织氧浓度和单线态氧产生等物理特性的能力不断进步,可能会使PDT期间的光传递能够进行精细的适应性调整,以优化治疗反应。最后,将分子靶向药物与新型光敏剂相结合,有可能进一步提高治疗指数,并将临床PDT的范围扩展到远远超出那篇标志性手稿撰写时的想象。《癌症研究》;76(9);2497 - 2499。©2016美国癌症研究协会。见多尔蒂等人的相关文章,《癌症研究》1978年;38:2628 - 2635。访问《癌症研究》75周年时间线。