Mĺkvy P, Messmann H, Regula J, Conio M, Pauer M, Millson C E, MacRobert A J, Bown S G
National Medical Laser Centre, University College London, Medical School, U.K.
Neoplasma. 1995;42(3):109-13.
5-Aminolaevulinic acid (ALA) is a promising agent for photodynamic therapy (PDT) sensitization as it can be given orally and only causes skin photosensitivity for 1-2 days. In fluorescence and photodynamic studies 26 patients with benign and malignant gastrointestinal tumors were given 30-60 mg ALA orally (single or divided doses) and biopsies were taken of tumor and normal tissue at 1-24 hours for fluorescence microscopy. With 30 mg/kg, highest protoporphyrin IX (PPIX) levels were seen in esophagus, duodenum and less in colon, but without tumor selectivity. Better tumor selectivity was seen in colon after 60 mg/kg (5:1). Six patients had transient rises in transaminases and five mild nausea. Sixteen patients were later treated (after further ALA) with red light (628 nm, bare or diffuser fibre, 50-100 J at 50 mW at each site). All but two showed subsequent necrosis, but only 0.5-1.5 mm of depth. PDT with ALA is simple, safe and promising for tumors in the gastrointestinal tract. Modification of treatment parameters may make it suitable for larger lesions.
5-氨基酮戊酸（ALA）是一种很有前景的光动力疗法（PDT）致敏剂，因为它可以口服，且只会导致1至2天的皮肤光敏性。在荧光和光动力研究中，26例患有良性和恶性胃肠道肿瘤的患者口服30至60毫克ALA（单次或分剂量），并在1至24小时内对肿瘤和正常组织进行活检，用于荧光显微镜检查。给予30毫克/千克时，食管和十二指肠中可见最高的原卟啉IX（PPIX）水平，结肠中的水平较低，但无肿瘤选择性。给予60毫克/千克后，结肠中可见更好的肿瘤选择性（5:1）。6例患者转氨酶短暂升高，5例有轻度恶心。16例患者后来（在进一步给予ALA后）接受了红光治疗（628纳米，裸光纤或漫射光纤，每个部位50毫瓦下50至100焦耳）。除2例患者外，所有患者随后均出现坏死，但深度仅为0.5至1.5毫米。ALA光动力疗法对于胃肠道肿瘤简单、安全且前景良好。治疗参数的调整可能使其适用于更大的病变。
