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激光辅助光动力疗法治疗增殖性疣状口腔白斑病。

Laser-assisted photodynamic therapy in proliferative verrucous oral leukoplakia.

机构信息

State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, PR China.

State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, PR China.

出版信息

Photodiagnosis Photodyn Ther. 2022 Sep;39:103002. doi: 10.1016/j.pdpdt.2022.103002. Epub 2022 Jul 6.

Abstract

Proliferative verrucous leukoplakia (PVL) is a rapidly progressing, easily relapsed, and cancer-prone oral potential malignant disease (OPMD), for which treatment options are currently limited. Non-invasive photodynamic therapy (PDT) uses specific wavelengths of light to excite photosensitizers and generate reactive oxygen species to induce cytotoxic effects, and it is selective for malignant tissues. However, the lesions of PVL often show hyperkeratosis, which limits the penetration of photosensitizers into the tissue and affects the effectiveness of PDT. Laser, a safe and efficient treatment, has shown great advantages in aiding photosensitizer delivery, due to its ability to accelerate the penetration of 5-aminolevulinic acid (5-ALA) and improve the accumulation of protoporphyrin IX (PPIX) in tissues. In the case report, we achieved complete remission and no recurrence at 8 months in a patient with PVL through laser-assisted PDT, which obtained satisfactory clinical effect and well protected the appearance and function of oral cavity.

摘要

增殖性疣状白斑(PVL)是一种快速进展、易复发且易恶变的口腔潜在恶性疾病(OPMD),目前治疗选择有限。非侵入性光动力疗法(PDT)利用特定波长的光来激发光敏剂并产生活性氧物质,从而诱导细胞毒性作用,对恶性组织具有选择性。然而,PVL 的病变常表现为过度角化,这限制了光敏剂进入组织的渗透,影响了 PDT 的效果。激光作为一种安全有效的治疗方法,由于其能够加速 5-氨基酮戊酸(5-ALA)的渗透并提高组织中原卟啉 IX(PPIX)的积累,在辅助光敏剂输送方面显示出了巨大的优势。在该病例报告中,我们通过激光辅助 PDT 使 PVL 患者在 8 个月时达到完全缓解且无复发,获得了满意的临床效果,并很好地保护了口腔的外观和功能。

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