New Aspects of Photodynamic Therapy for Central Type Early Stage Lung Cancer
New Aspects of Photodynamic Therapy for Central Type Early Stage Lung Cancer
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DOI：
10.1002/lsm.21091
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发表时间：
2011-09-01
影响因子：
2.4
通讯作者：
Tsutsui, Hidemitsu
中科院分区：
文献类型：
--
作者：
Ikeda, Norihiko;Usuda, Jitsuo;Tsutsui, Hidemitsu
背景资料：目的光动力学疗法（Photodynamic therapy，PDT）已成为治疗中心型早期肺癌（Central type early stage lung cancer，CELC）的首选方法。最近的进展，以诊断CELC的能力，在光敏剂，以及复杂的临床管理，可能会提高治疗效果，扩大适应症的PDT.Materials和Methods：我们做了搜索的论文PDT肺癌选择最相关的文章。基于这一审查和我们最近的数据，我们讨论了最好的证据诊断，定义的适应症，光敏剂，和临床管理方面的PDT.Results：获得完全响应（CR）的PDT，选择的适应症是非常重要的，包括肿瘤的程度在支气管表面和浸润的深度在支气管壁。自体荧光支气管镜检查（AFB）和支气管内超声检查（EBUS）的发展对CELC的诊断性支气管镜检查产生了很大的影响。直径小于1cm的CELC显示出良好的PDT治愈率，因此这是PDT的良好指征。相对较新的光敏剂NPe 6具有比Photofrin更强的抗肿瘤作用，即使对于直径>1.0 cm的大肿瘤也显示出类似的治疗结果。此外，综合管理，包括光动力学诊断前和后PDT应有效地减少局部复发的可能性PDT后。结论：目前的指南PDT CELC建立的基础上，从研究中获得的数据在20世纪80年代。我们推测，综合诊断和新一代光敏剂可能会增加CR率，扩大PDT治疗较大肿瘤的适应症。激光外科医学43：749-754，2011。(C)2011 Wiley-Liss，Inc.
Background: and Objective Photodynamic therapy (PDT) has come to be considered as the first choice of treatment for central type early stage lung cancer (CELC). Recent advances in the ability to diagnose CELC, and in photosensitizers, as well as sophisticated clinical management, may improve the therapeutic outcome and expand the indications of PDT.Materials and Methods: We made the search for papers on PDT for lung cancer to select the most relevant articles. Based on this review and our recent data, we discussed the best available evidence for the diagnosis, the definition of indications, photosensitizers, and clinical management with regard to PDT.Results: To obtain complete response (CR) by PDT, the selection of the indications is extremely important, including the extent of the tumor on the bronchial surface and the depth of invasion in the bronchial wall. The development of autofluorescence bronchoscopy (AFB) and endobronchial ultrasonography (EBUS) have had a large impact on diagnostic bronchoscopy for CELC. CELCs less than 1 cm in diameter showed a favorable cure rate by PDT, thus this is a good indication for PDT. The relatively newer photosensitizer NPe6, which has a stronger antitumor effect than Photofrin, showed similar treatment outcome even for large tumors >1.0 cm in diameter. Furthermore, comprehensive management including photodynamic diagnosis before and after PDT should be effective to minimize the possibility of local recurrence after PDT.Conclusion: The present guidelines of PDT for CELC were established based on the data obtained from studies in the 1980's. We postulate that comprehensive diagnosis and the new generation of photosensitizers may increase the CR rate and expand the indications of PDT for larger tumors. Lasers Surg. Med. 43: 749-754, 2011. (C) 2011 Wiley-Liss, Inc.