Kessel David
Department of Pharmacology, Wayne State University School of Medicine, Detroit, MI, USA.
Photochem Photobiol. 2023 Mar;99(2):199-203. doi: 10.1111/php.13616. Epub 2022 Mar 24.
Photodynamic therapy can be useful for the eradication of malignant cells at sites that are accessible to light delivery. There are few adverse effects, with many clinical reports indicating that PDT has curative potential. Patients with minimal disease, where success is more likely, are also sought by those promoting other protocols. New photosensitizing agents that initiate light-catalyzed reactions continue to be discovered. Reports describing advances in understanding fundamental aspects of photobiology are always of interest. But, implications for treatment of neoplasia and other diseases are not always justified, especially when poorly penetrating wavelengths of light are employed, often at very high light doses. Efficacy is sometimes estimated by protocols that may not accurately measure photokilling. Many reports claiming potential clinical relevance for in vitro observations are based on a limited understanding of the determinants of clinical efficacy. The future of photodynamic therapy depends on an appreciation of what can be accomplished, especially when used with other modalities, but will also depend on the goals and interests of granting agencies, pharmaceutical groups, and clinical personnel. This commentary is intended to provide some thoughts on current research efforts, especially where clinical implications are suggested, hinted at or otherwise implied.
光动力疗法对于清除可进行光传输部位的恶性细胞可能是有用的。其不良反应较少，许多临床报告表明光动力疗法具有治愈潜力。那些推广其他治疗方案的人也在寻找病情较轻、更有可能成功的患者。能够引发光催化反应的新型光敏剂不断被发现。描述光生物学基本方面进展的报告总是备受关注。但是，对于肿瘤和其他疾病治疗的影响并不总是合理的，特别是当使用穿透性差的光波长时，通常光剂量非常高。疗效有时是通过可能无法准确测量光杀伤作用的方案来评估的。许多声称体外观察具有潜在临床相关性的报告是基于对临床疗效决定因素的有限理解。光动力疗法的未来取决于对所能取得成果的认识，特别是与其他治疗方式联合使用时，但也将取决于资助机构、制药集团和临床人员的目标和兴趣。本评论旨在对当前的研究工作提供一些思考，特别是那些暗示、提示或以其他方式隐含临床意义的研究。
