Tochner Z A, Pass H I, Smith P D, DeLaney T F, Sprague M, DeLuca A M, Harrington F, Thomas G F, Terrill R, Bacher J D
Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892.
Lasers Surg Med. 1994;14(2):118-23. doi: 10.1002/1096-9101(1994)14:2<118::aid-lsm1900140204>3.0.co;2-5.
Surgery with intraoperative photodynamic therapy (PDT) has the potential to improve the treatment of pleural malignancies. Before embarking on such treatment in humans, however, thoracic tissue tolerance to PDT was studied. For each of three (1 week, 1 month, and 6 month) study end-points, one control (no Photofrin II [PII]) and four treated animals underwent thoracotomy 72 hours after I.V. injection (6 mg/kg) PII. Red light (630 nm) was delivered (5-40 J/cm2) to the pleural surface (1 cm diameter) of selected thoracic organs. No clinical differences were observed between PDT and control dogs. The control showed no histological changes; however, in the treated animals focal areas of coagulation necrosis were found at 1 week which progressed to fibrosis at 1 month. The extent and depth of injury was proportional to light dose. The lung was the most sensitive; the chest wall was the most resistant. Myocardium had superficial damage, whereas coronary arteries appeared normal. The results provide the basis for proceeding to phase I human trials in the evaluation of PDT as an intraoperative adjuvant treatment in the management of pleural malignancies.
术中光动力疗法（PDT）手术有改善胸膜恶性肿瘤治疗效果的潜力。然而，在对人类开展此类治疗之前，对胸部组织对PDT的耐受性进行了研究。对于三个研究终点（1周、1个月和6个月）中的每一个，在静脉注射（6mg/kg）二血卟啉醚（PII）72小时后，对1只对照动物（未注射PII）和4只接受治疗的动物进行开胸手术。将红光（630nm）照射（5 - 40J/cm²）到选定胸部器官的胸膜表面（直径1cm）。在接受PDT治疗的犬和对照犬之间未观察到临床差异。对照犬未出现组织学变化；然而，在接受治疗的动物中，在1周时发现有局灶性凝固性坏死区域，在1个月时进展为纤维化。损伤的范围和深度与光剂量成正比。肺最敏感；胸壁最耐受。心肌有浅表损伤，而冠状动脉看起来正常。这些结果为开展I期人体试验以评估PDT作为胸膜恶性肿瘤术中辅助治疗方法提供了依据。
