胆管癌光动力治疗的基础与临床研究新进展

New progress in basic and clinical research of photodynamic therapy for cholangiocarcinoma

胆管癌起病隐匿且恶性程度极高,大多数病人初诊时已是晚期,失去了根治性手术的机会,不可切除的胆管癌病人生存期极短且生存质量较低。目前对于不可切除的胆管癌的常见治疗方法有胆道支架、放化疗、射频消融、靶向和免疫治疗等,但由于胆道肿瘤恶性程度高,放化疗不敏感且易发生耐药,现有治疗手段对病人生存时间和生存质量的提升亦有限。因此,临床医生亟需探索新的治疗策略以突破当下的困境。光动力疗法作为一种治疗胆管癌的新手段,以其优异的局部抗肿瘤效果引起广泛关注。本文主要针对近年来光敏剂的研制和发展、光动力治疗(PDT)的分子作用机制、PDT的临床应用等相关情况进行归纳总结,结合我们团队开展的相应临床工作,阐述PDT研究的热点和潜力,为临床及科研提供参考。

The onset of cholangiocarcinoma is insidious and the degree of malignancy is extremely high.Most of the patients are already in the advanced stage when they are first diagnosed and have lost the opportunity of radical surgery.The prognosis of patients is poor and the quality of life is low.Currently,the common treatment methods for unresectable cholangiocarcinoma include biliary stent,radiotherapy and chemotherapy,radiofrequency ablation,targeted therapy and immunotherapy,etc.However,due to the poor degree of malignancy of biliary duct tumor,radiotherapy and chemotherapy are not sensitive and prone to drug resistance,the existing treatment methods are limited in improving the survival time and quality of life of patients.Therefore,clinicians urgently need to explore new treatment strategies to overcome the current dilemma.Photodynamic therapy(PDT),as a new treatment for cholangiocarcinoma,has attracted attention due to its excellent local anti-tumor effect.In this paper,the research and development of photosensitizers,the molecular mechanism,and the clinical application of PDT in recent years are summarized.Combined with the corresponding clinical work carried out by the author’s team,the spots and potential of PDT research are described,so as to provide references for clinical and scientific research.