Breast cancer with chest wall progression: Treatment with photodynamic therapy
Breast cancer with chest wall progression: Treatment with photodynamic therapy
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DOI：
10.1245/aso.2004.03.025
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发表时间：
2004-03-01
影响因子：
3.7
通讯作者：
Downie, GH
中科院分区：
文献类型：
--
作者：
Cuenca, RE;Allison, RR;Downie, GH
背景：乳腺癌的胸壁进展影响高达 5% 的乳腺癌患者，并且是其疼痛的主要来源。这些患者的治疗选择有限或可能无法提供。低剂量 Photofrin 诱导的光动力疗法 (PDT) 可提供出色的临床反应和最低的发病率。我们报告了我们在这种情况下使用 PDT 的持续经验。方法：14 名具有超过 500 个躯干转移灶的患者接受了 PDT 治疗。所有患者均接受标签外 Photofrin (0.8 mg/kg) IV 治疗，并使用带有微透镜的二极管激光器在 630 nm 下进行光治疗，注量为 1800 mW，总光剂量为 150 至 200 J/cm(2)，48 小时。一名患者因病情广泛需要重新治疗。结果：随访时间至少为 6 个月，部分患者延长至 >24 个月。所有患者均表现出肿瘤坏死，14 名患者中有 9 名完全缓解，包括病变厚度 >2 厘米。疾病进展发生在治疗范围之外。一些患者未经治疗的病变已初步消退。伤口护理，尤其是深部组织疾病的伤口护理是一个问题。结论：低剂量 Photofrin 诱导的 PDT 为胸壁进展患者提供了一种具有良好临床反应的治疗选择。迄今为止，响应时间较长，并提供了良好的本地控制。肿瘤外科医师在这种治疗选择中发挥着积极作用。
Background: Chest wall progression of breast carcinoma affects up to 5% of breast cancer patients and is a major source of their pain. Treatment options are limited or may not be offered to these patients. Low-dose Photofrin-induced photodynamic therapy (PDT) offers an excellent clinical response with minimal morbidity. We report our continued experience with PDT in this setting.Methods: Fourteen patients with more than 500 truncal metastases were treated with PDT. All received off-label Photofrin (.8 mg/kg) IV and light treatment at 630 run from a diode laser with a microlens at a fluence of 1800 mW and a total light dose of 150 to 200 J/cm(2) at 48 hours. One patient required re-treatment because of extensive disease.Results: Follow-up was at least 6 months, and several extended to >24 months. All patients demonstrated tumor necrosis, with 9 of 14 complete responses, including with lesions >2 cm in thickness. Disease progression occurred outside of the treatment field. Several patients had initial regression of untreated lesions. Wound care, especially with disease in the deep tissues, was an issue.Conclusions: Low-dose Photofrin-induced PDT offers patients with chest wall progression a treatment option with an excellent clinical response. To date, the response is prolonged and offers good local control. Surgical oncologists have an active role in this treatment option.