Musani Ali I, Veir Julia K, Huang Zheng, Lei Tim, Groshong Steve, Worley Deanna
Interventional Pulmonology, Pulmonary and Critical Care Medicine, Departments of Medicine and Surgery, University of Colorado Medical School, Denver, Colorado, 80045.
Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, 80523.
Lasers Surg Med. 2018 Jul;50(5):483-490. doi: 10.1002/lsm.22781. Epub 2018 Feb 5.
In the setting of lung cancer, photodynamic therapy (PDT) is typically used to treat centrally located endobronchial tumors. The development of navigational bronchoscopy has opened the potential for using PDT to treat peripheral lung tumors. However, there is limited information about the feasibility of this approach for treating peripheral lung cancers, and about its effects on surrounding healthy lung tissue. We studied the use of PDT delivered by electromagnetic navigational bronchoscopy to treat peripheral lung cancer in dogs.
Three dogs with peripheral lung adenocarcinomas were given intravenous porfimer sodium (Photofrin® [Pinnacle Biologics, Inc., Chicago, IL]) to photosensitize the tumors, then navigational bronchoscopy was used to deliver photoradiation. One week after PDT, the tumors and involved lung lobe were surgically excised and evaluated histologically.
PDT was successful in all three dogs and was associated with tolerable and manageable adverse effects. Tissue sections from within PDT-treated tumors showed regions of coagulative central necrosis admixed with small numbers of inflammatory cells, and arterial thrombosis. Viable adenocarcinoma was seen in the surrounding areas.
These results suggest that PDT can be successfully deployed to treat peripheral lung cancers using navigational bronchoscopy. Furthermore, damage to surrounding noncancerous tissues can be minimized with accurate placement of the optical fiber. Studies of this modality to treat peripheral lung cancers in humans may be warranted. Lasers Surg. Med. 50:483-490, 2018. © 2018 Wiley Periodicals, Inc.
在肺癌治疗中,光动力疗法(PDT)通常用于治疗位于中央的支气管内肿瘤。导航支气管镜的发展为使用PDT治疗周围型肺肿瘤开辟了可能性。然而,关于这种方法治疗周围型肺癌的可行性及其对周围健康肺组织的影响的信息有限。我们研究了通过电磁导航支气管镜进行光动力疗法治疗犬周围型肺癌的应用。
三只患有周围型肺腺癌的犬静脉注射卟啉钠(Photofrin®[品尼高生物制品公司,伊利诺伊州芝加哥])以使肿瘤光敏化,然后使用导航支气管镜进行光辐射。光动力疗法一周后,手术切除肿瘤及受累肺叶并进行组织学评估。
三只犬的光动力疗法均成功,且伴有可耐受和可控制的不良反应。光动力疗法治疗的肿瘤组织切片显示中央凝固性坏死区域伴有少量炎性细胞及动脉血栓形成。在周边区域可见存活的腺癌。
这些结果表明,使用导航支气管镜光动力疗法可成功用于治疗周围型肺癌。此外,通过准确放置光纤可将对周围非癌组织的损伤降至最低。对这种治疗人类周围型肺癌方式的研究可能是必要的。《激光外科与医学》50:483 - 490,2018年。©2018威利期刊公司