Unit of Orthopedic Oncology, Hillel-Yaffe Medical Center, Hadera, Israel; Affiliated to the Rappaport Faculty of Medicine, Technion, Israel.
National Unit of Orthopedic Oncology, Tel-Aviv Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Photodiagnosis Photodyn Ther. 2023 Jun;42:103624. doi: 10.1016/j.pdpdt.2023.103624. Epub 2023 May 20.
Fibroblastic soft-tissue tumors share enzymatic anomalies that result in excessive intracellular conversion of 5-aminolevulinic acid (5-ALA) to protoporphyrin IX, a photosensitizer which induces cellular apoptosis upon exposure to visible red light at a wavelength of 635 nm. We hypothesized that red light illumination of the surgical bed remaining after resection of fibroblastic tumors will result in destruction of microscopic tumor residua and may decrease the likelihood of local tumor recurrence.
Twenty-four patients with desmoid tumors, solitary fibrous tumors (SFT), and dermatofibrosarcoma protuberans (DFSP) received oral 5-ALA prior to resection of their tumors. Following tumor resection, the exposed surgical bed was illuminated with red light at a wave length of 635 nm at a dose of 150 J/cm for 33 min.
Treatment with 5-ALA was associated with minor side effects that included nausea and transient elevation of transaminases. Local tumor recurrence was detected in 1 of the 10 patients with desmoid tumors who had not undergone any previous surgery, none in the 6 patients who had SFT and 1 of the 5 patients who had DFSP.
5-ALA photodynamic therapy of fibroblastic soft-tissue tumors may result in decreased likelihood of local tumor recurrence. It is associated with minimal side effects and should be considered as adjuvant to tumor resection in these cases.
成纤维细胞性软组织肿瘤存在酶学异常，导致 5-氨基酮戊酸（5-ALA）在细胞内过度转化为原卟啉 IX，一种光敏剂，在波长为 635nm 的可见光照射下诱导细胞凋亡。我们假设切除成纤维细胞瘤后，对残留的手术床进行红光照射，将导致微肿瘤残留的破坏，并可能降低局部肿瘤复发的可能性。
24 例患有硬纤维瘤、孤立性纤维瘤（SFT）和隆突性皮肤纤维肉瘤（DFSP）的患者在切除肿瘤前口服 5-ALA。肿瘤切除后，用波长为 635nm 的红光在暴露的手术床上进行照射，剂量为 150J/cm，持续 33 分钟。
5-ALA 治疗的副作用较小，包括恶心和转氨酶一过性升高。在未行任何既往手术的 10 例硬纤维瘤患者中，有 1 例出现局部肿瘤复发，在 6 例 SFT 患者中无一例，在 5 例 DFSP 患者中有 1 例。
5-ALA 光动力疗法治疗成纤维细胞性软组织肿瘤可降低局部肿瘤复发的可能性。它的副作用极小，在这些情况下应考虑作为肿瘤切除的辅助治疗。
