Clinical evaluation of a mobile, low-cost system for fluorescence guided photodynamic therapy of early oral cancer in India.
Clinical evaluation of a mobile, low-cost system for fluorescence guided photodynamic therapy of early oral cancer in India.
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DOI：
10.1016/j.pdpdt.2022.102843
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发表时间：
2022-06
影响因子：
3.3
通讯作者：
Hasan T
中科院分区：
文献类型：
--
作者：
Siddiqui SA;Siddiqui S;Hussain MAB;Khan S;Liu H;Akhtar K;Hasan SA;Ahmed I;Mallidi S;Khan AP;Cuckov F;Hopper C;Bown S;Celli JP;Hasan T
在印度，口腔癌的发病率和死亡率因医疗服务不足的人群缺乏有效治疗而加剧。我们开发了一种用户友好的低成本便携式光纤耦合LED系统，用于早期口腔病变的光动力治疗（PDT），使用智能手机荧光成像设备进行治疗指导，并使用3D打印光纤附件进行符合人体工程学的口内光传输。从JN医学院诊所、Aligarh和农村筛查营地招募了30名T1 N 0 M0颊粘膜癌患者。通过外部超声（US）、白色光照片和口服光敏剂ALA（60 mg/kg，分次给药）后肿瘤荧光增加（通过智能手机荧光成像装置监测）定义肿瘤限值。递送100 J/cm 2 LED光（635 nm峰值），随后重复荧光以评估光漂白。术后7-17天复查超声和活检。本试验在ClinicalTrials.gov注册，NCT 03638622，研究已完成。无明显并发症或不适。无需镇静。完成研究的30例患者中有22例未检测到残留病变（34处病变中有26处，76%的肿瘤完全缓解，中位随访时间为50周），坏死深度高达7.2 mm。治疗失败归因于肿瘤尺寸大和/或光输送不足（通过有限的光漂白记录）。中等分化的病变比高分化的癌症更敏感。这种简单且低成本的图像引导光动力学疗法可有效治疗早期恶性口腔病变，并可能对全球健康产生影响。美国国家癌症研究所
Morbidity and mortality due to oral cancer in India are exacerbated by a lack of access to effective treatments among medically underserved populations. We developed a user-friendly low-cost, portable fibre-coupled LED system for photodynamic therapy (PDT) of early oral lesions, using a smartphone fluorescence imaging device for treatment guidance, and 3D printed fibreoptic attachments for ergonomic intraoral light delivery. 30 patients with T1N0M0 buccal mucosal cancer were recruited from the JN Medical College clinics, Aligarh, and rural screening camps. Tumour limits were defined by external ultrasound (US), white light photos and increased tumour fluorescence after oral administration of the photosensitising agent ALA (60 mg/kg, divided doses), monitored by a smartphone fluorescence imaging device. 100 J/cm2 LED light (635 nm peak) was delivered followed by repeat fluorescence to assess photobleaching. US and biopsy were repeated after 7-17 days. This trial is registered with ClinicalTrials.gov, NCT03638622, and the study has been completed. There were no significant complications or discomfort. No sedation was required. No residual disease was detected in 22 out of 30 patients who completed the study (26 of 34 lesions, 76% complete tumour response, 50 weeks median follow-up) with up to 7.2mm depth of necrosis. Treatment failures were attributed to large tumour size and/or inadequate light delivery (documented by limited photobleaching). Moderately differentiated lesions were more responsive than well-differentiated cancers. This simple and low-cost adaptation of image-guided PDT is effective for treatment of early-stage malignant oral lesions and may have implications in global health. US National Cancer Institute
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影响因子：
1.9
作者：
Smiley, Nicholas;Anzai, Yoshimi;Dillon, Jasjit
通讯作者：
Dillon, Jasjit
影响因子：
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Uthoff, Ross D.;Song, Bofan;Liang, Rongguang
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Liang, Rongguang
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REGULA, J;MACROBERT, AJ;BOWN, SG
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BOWN, SG
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Betz, CS;Stepp, H;Leunig, A
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Regula, J.;Ravi, B.;Bedwell, J.;Macrobert, A. J.;Bown, S. G.
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Bown, S. G.