光动力疗法在头颈部恶性肿瘤中的应用

Application of photodynamic therapy in malignant tumors of head and neck

光动力治疗是近些年不断兴起的肿瘤治疗手段,将光敏剂注射到体内后,光敏剂能特异性聚集在肿瘤组织中,再予以特定波长的光照射肿瘤部位,使光敏剂产生光动力学反应,使肿瘤细胞器损伤、肿瘤细胞凋亡及坏死、肿瘤微循环障碍、机体肿瘤免疫等作用机制杀死肿瘤细胞。近年来,作为光动力疗法的关键因素,新的光敏剂及光源不断被探索并应用于临床,关于光动力治疗恶性肿瘤的临床研究日益增多,尤其是头颈部恶性肿瘤。随着新型光敏剂如金丝桃素及相关光源投入使用以及将光动力技术与其他治疗手段相结合后,光动力治疗效果主要观察指标“生存时间”较既往有所延长,相关不良反应如日光性皮炎、药物过敏反应等有所减少,且其在保存重要器官功能完整和美容功能上令人满意。本文对近年来光动力治疗在头颈部恶性肿瘤的临床应用做一综述,重点阐述光动力治疗鼻咽癌、鼻窦癌、喉癌、口腔癌、面部皮肤恶性肿瘤等头颈部常见恶性肿瘤时所体现的疗效好、完整保存重要器官功能、美容及副作用小的优越性,以了解近些年光动力技术对头颈部恶性肿瘤疗效的发展,及表达需进一步研发性能更优的光敏剂和光源、寻找光动力疗法结合其他治疗手段的需求。

Photodynamic therapy(PDT)is an emerging tumor therapy method in recent years.After the photosensitizer injected into the body,it specifically accumulates in the tumor tissue and then illuminate the tumor site with a specific wavelength of light,causing the photodynamic reaction、tumor cell organelle damage、tumor cell apoptosis and necrosis and tumor immunity to kill the malignancy.Recently,as the key factors of photodynamic therapy,new photosensitizer and light source have been continuously explored and applied in clinical practice.There are more clinical studies on photodynamic therapy for malignant tumors,especially head and neck malignancies.With the introduction of new photosensitizers such as hypericin and associated light sources and the combination of photodynamic techniques with other treatments,the main observation indicator of the effect of photodynamic therapy,"survival time",has been extended.The related adverse reactions such as solar dermatitis and drug allergic reaction have been reduced.In addition,its preservation of vital organ function integrity and cosmetic function is satisfactory.This article reviews the clinical application of PDT in head and neck malignant tumors in recent years.We focused on the advantages of good effect,preserving functional integrity of important organs,beauty and less side effects in photodynamic treatment of nasopharyngeal carcinoma,sinus carcinoma,laryngeal cancer,oral cancer,ficial skin cancer and other common head and neck malignancies.It could better understand the development of photodynamic technology and express the need for better photosensitizer and light source and photodynamic therapy combined with other treatment methods.