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恶性胶质瘤的光动力疗法

Photodynamic Therapy of Malignant Gliomas.

作者信息

Kaneko Sadao, Fujimoto Shin, Yamaguchi Hideshi, Yamauchi Toru, Yoshimoto Tetsuya, Tokuda Koichi

出版信息

Prog Neurol Surg. 2018;32:1-13. doi: 10.1159/000469675. Epub 2018 Jul 10.

Abstract

Recently, the clinical applications of photodynamic therapy (PDT) in the management of malignant brain tumors have attracted significant attention. Meta-analysis of the observational studies on this treatment in high-grade gliomas (Eljamel, 2010) included more than 1,000 patients and reported median survival in cases of newly diagnosed and recurrent glioblastoma multiforme (GBM) of 16.1 and 10.3 months, respectively. In some series, increase in the long-term survival rates was also observed. Few controlled trials demonstrated statistically significant impact of PDT on prolongation of survival in patients with GBM in comparison to conventional management. The main treatment-related adverse event is short-lasting excessive photosensitivity of the skin and retina after photosensitizer administration, but its negative consequences can be easily avoided with appropriate protective measures. Overall, PDT may be considered to be a safe and effective adjuvant therapeutic option for patients with newly diagnosed and recurrent malignant gliomas. Aggressive tumor resection seems to be an important prerequisite to maximize treatment efficacy.

摘要

最近,光动力疗法(PDT)在恶性脑肿瘤治疗中的临床应用引起了广泛关注。对高级别胶质瘤中该治疗的观察性研究进行的荟萃分析(Eljamel,2010年)纳入了1000多名患者,并报告新诊断和复发性多形性胶质母细胞瘤(GBM)患者的中位生存期分别为16.1个月和10.3个月。在一些系列研究中,还观察到长期生存率有所提高。与传统治疗相比,很少有对照试验证明PDT对GBM患者生存期延长有统计学意义的影响。主要的治疗相关不良事件是给予光敏剂后皮肤和视网膜出现短暂的过度光敏反应,但通过适当的保护措施可以很容易地避免其负面影响。总体而言,对于新诊断和复发性恶性胶质瘤患者,PDT可被视为一种安全有效的辅助治疗选择。积极的肿瘤切除似乎是最大化治疗效果的重要前提。

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