Manyak M J, Matthews D M, Smith P D, Nochomovitz L E, Russo A
National Cancer Institute, Radiation Oncology Branch, Bethesda, MD 20892.
Lasers Surg Med. 1988;8(3):301-7. doi: 10.1002/lsm.1900080313.
Normal urethral response to photodynamic therapy (PDT) utilizing a cylindrical fiber was assessed in ten study and two control NIH fox-hounds. The canine urethras were treated 48 hours after intravenous injection of 3 mg/kg dihematoporphyrin ether (Photofrin II). A 1-mm fused silica optical fiber, with the distal 2-3 cm modified for cylindrical light distribution (660-microns diameter), was placed in the pendulous urethra. An argon-pumped dye laser delivered 100 mW of 630-nm light for 7 minutes (42 J) to the treatment area. Urethroscopy using either a 2.5-mm or a 2.8-mm flexible pediatric bronchoscope with video recording capability was performed immediately after PDT (12 animals) and 6 weeks later (nine animals); intravenous urography was performed 3 days and 6 weeks after PDT. There was no evidence of either urethral damage or stricture formation in any animal. Histopathology of the first three study specimens, obtained at 6 weeks, confirmed the absence of any pathology. Flexible instrumentation facilitates post-treatment assessment. This study demonstrates for the first time that, when a cylindrical fiber is used, photodynamic therapy may be applied to the urethra without damage to the normal urethral mucosa. This result has implications for potential treatment of initial or recurrent carcinoma in situ of the urethra using PDT.
在十只研究用和两只对照用的美国国立卫生研究院(NIH)猎狐犬中评估了利用圆柱形光纤进行光动力疗法(PDT)时尿道的正常反应。在静脉注射3mg/kg的二血卟啉醚(Photofrin II)48小时后对犬的尿道进行治疗。将一根1mm的熔融石英光纤放置在悬垂部尿道中,该光纤远端2 - 3cm经改良以实现圆柱形光分布(直径660微米)。一台氩泵浦染料激光器向治疗区域输送100mW的630nm光,持续7分钟(42焦耳)。在PDT后立即(12只动物)和6周后(9只动物),使用具有视频记录功能的2.5mm或2.8mm柔性小儿支气管镜进行尿道镜检查;在PDT后3天和6周进行静脉肾盂造影。在任何动物中均未发现尿道损伤或狭窄形成的证据。在6周时获取的前三份研究标本的组织病理学检查证实无任何病理改变。柔性器械有助于治疗后的评估。本研究首次证明,当使用圆柱形光纤时,光动力疗法可应用于尿道而不损伤正常尿道黏膜。这一结果对使用PDT治疗尿道原位癌的初始或复发病例具有潜在意义。