Photodynamic therapy for mesothelioma.
Photodynamic therapy for mesothelioma.
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DOI：
10.1007/s11864-001-0042-4
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发表时间：
2001-10-01
影响因子：
4.3
通讯作者：
Friedberg, J
中科院分区：
文献类型：
--
作者：
Hahn, S M;Smith, R P;Friedberg, J
恶性胸膜间皮瘤的传统癌症治疗（包括手术，放疗和化疗）的多项试验尚未令人信服地证明任何一种治疗上级单独的支持治疗。尽管有报告称长期存活者接受了侵袭性手术联合放疗和侵袭性多药化疗方案治疗，但这些患者人群是高度选择性的，结果不能推广到更大的人群。尽管尝试使用积极的多模态治疗，疾病复发在大多数患者。局部失败，特别是间皮瘤的自然史的很大一部分，特别是手术后单独。因此，开发新治疗方法的主要考虑因素之一是纳入积极的局部治疗。光动力疗法（PDT），一种局部治疗方式，正在评估作为手术切除的辅助治疗。PDT的临床使用需要使用光敏剂和在氧存在下对敏化剂的吸收特性具有特异性的波长的光。PDT的治疗效果是表面的，主要是因为组织中光吸收的深度有限。因此，从理论上讲，它是外科减积手术后组织表面和体腔的理想治疗方法。PDT的一个理论优势是它可以用于治疗胸膜切除术后的肺表面;因此，患者可以用胸膜切除术而不是胸膜外全肺切除术治疗。几项研究已经评估了PDT治疗间皮瘤的疗效。临床研究尚未令人信服地证明PDT的使用上级其他辅助治疗或单独手术。新的光敏剂和改进的激光技术的出现导致了对PDT评估的新兴趣。进一步的研究是必要的，以确定PDT在间皮瘤治疗中的作用。
Multiple trials of traditional cancer therapies for malignant pleural mesothelioma (including surgery, radiation therapy, and chemotherapy) have not convincingly demonstrated that any one treatment is superior to supportive care alone. Although there have been reports of long-term survivors who were treated with aggressive surgery combined with radiation and aggressive multi-agent chemotherapeutic regimens, these patient populations are highly selected and results cannot be generalized to a larger population. Despite attempts to use aggressive multimodality therapies, disease recurs in most patients. Local failure in particular is a large part of the natural history of mesothelioma, especially after surgery alone. Therefore, one of the major considerations in the development of new treatments is the inclusion of aggressive local therapies. Photodynamic therapy (PDT), a local treatment modality, is being evaluated as an adjuvant therapy to surgical resection. Clinical use of PDT requires the use of a photosensitizing agent and light of a wavelength specific to the absorption characteristics of the sensitizer in the presence of oxygen. The treatment effect of PDT is superficial, mostly because of the limited depth of light absorption in tissues. Therefore, it is theoretically an ideal treatment for tissue surfaces and body cavities after surgical debulking procedures. One theoretical advantage of PDT is that it can be used to treat the lung surface after a pleurectomy; therefore, patients may be treated with a pleurectomy rather than with an extrapleural pneumonectomy. Several studies have evaluated the efficacy of PDT in the treatment of mesothelioma. Clinical studies have not proven convincingly that the use of PDT is superior to the use of other adjuvant therapies or to surgery alone. The advent of newer photosensitizers and improved laser technology has led to a renewed interest in evaluating PDT. Additional studies are necessary to determine the role of PDT in the treatment of mesothelioma.