光动力学治疗外眼黑色素瘤的远期效应

Long-term Effect of Photodynamic Therapy on Melanoma of External Eyes

应用血卟啉衍生物和激光辐照治疗外眼黑色素瘤7例、痣恶性变5例。辐照前48小时静脉滴注或局部注射HpD光敏剂,先用氩离子激光点状光斑接触照射清除可见瘤组织,后用红色激光点状光斑扫描式辐照30分钟,以杀伤残存瘤细胞。结果12例完全消退,随访最长者6年,最短者2年未见复发。激光联合辐照以接触照射使瘤组织立刻凝固、炭化、汽化,再对创面行扫描式光动力辐照以杀伤残存瘤细胞,可发挥协同作用,提高疗效。

Seven cases of blepharal or conjunctival melanomas and five cases of malignant nevi were treated by scanning pbotoradiation with hematoporphyrin derivative (HpD) and argon pumped dye laser (APDL). HpD was given i.v.or by local injection, if the tumor was small enough, 48 hours prior irradiation. All visible tumors were at first cleared up by contact argon spot laser, then irradiated for 30 minutes by APDL to kill the residual tumor cells. All of the tumors disappeared completely with no recurrence and metastasis after 2 to 6 years' follow-up. The results are very promising and indicate since the contact irradiation with argon spot laser causes immediate coagulation, evaporation and charring of the tumor tissue and the following scanning irradiation with APDL may further kill the residual tumor cells, tbe treatment combining the two irradiation procedures may considerably improve the therapeutic results of treatment of the malignant tumors.