Mordon Serge, Vignion-Dewalle Anne S, Thecua Elise, Vicentini Claire, Maire Cyril, Deleporte Pascal, Baert Gregory, Lecomte Fabienne, Mortier Laurent
Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille University, Lille, France - serge.mordon @inserm.fr.
Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille University, Lille, France.
G Ital Dermatol Venereol. 2018 Dec;153(6):811-816. doi: 10.23736/S0392-0488.18.05907-2. Epub 2018 Feb 7.
Natural DayLight-mediated PhotoDynamic Therapy (NDL-PDT) is an efficacious treatment option for thin actinic keratosis that offers advantages over conventional PDT in terms of tolerability and cost. It is now accepted that the minimum criteria required for effective NDL-PDT is a dose of 4 J/cm² with a treatment time of 2 hours and a minimum temperature of 10 °C, corresponding to a minimum illuminance of 11,000 lux. This value is easily achievable: 20,000 lux can be obtained during a typical overcast day at midday. It can reach 110,000 lux with a bright sunlight. However, it is limited to certain times of the year at our latitude. However rain and cold temperatures appear the main limitations of NDL-PDT. Greenhouses make possible to perform the illumination even in harsh weather conditions. Furthermore, it is difficult to install a greenhouse everywhere. Several solutions are now proposed to carry out indoor illumination so-called artificial white light or simulated daylight (SDL-PDT). Illumination sources installed at the ceiling of the treatment room is one option. Several lamp pairs can be combined to illuminate groups of patients simultaneously. A surgical theatre light can be used or dedicated systems using white LEDs can be used to deliver the required illumination dose. In conclusion, Indoor lightning (or simulated daylight: SDL-PDT or Artificial White Light: AWL) could offer an interesting alternative to NDL-PDT.
自然日光介导的光动力疗法（NDL-PDT）是治疗轻度光化性角化病的一种有效方法，在耐受性和成本方面优于传统光动力疗法。目前公认，有效的NDL-PDT所需的最低标准是剂量为4 J/cm²，治疗时间为2小时，最低温度为10°C，对应最低照度为11000勒克斯。这个值很容易实现：在典型的阴天中午可以获得20000勒克斯的照度。在强烈阳光下可达到110000勒克斯。然而，在我们所在的纬度地区，这仅限于一年中的某些时段。然而，降雨和低温似乎是NDL-PDT的主要限制因素。温室使得即使在恶劣天气条件下也能进行光照。此外，在任何地方都很难安装温室。现在提出了几种解决方案来进行室内照明，即所谓的人工白光或模拟日光（SDL-PDT）。安装在治疗室天花板上的照明源是一种选择。可以组合多个灯对同时照亮多组患者。可以使用手术无影灯或使用白色发光二极管的专用系统来提供所需的照明剂量。总之，室内照明（或模拟日光：SDL-PDT或人工白光：AWL）可能是NDL-PDT的一个有趣替代方案。
