光动力疗法根治早期癌有潜力徐克成.ppt

* * * * * * * * * * * * * * * PDT治疗喉癌 【李黎波等，2003】 治疗前　　　　　　　　 治疗后 乳腺癌皮肤转移：光动力治疗 治疗前 治疗后 直肠肿瘤：光动力治疗 治疗前直肠肿瘤阻塞 治疗后通畅 膀胱癌：光动力+碘粒子植入治疗 膀胱镜下PDT治疗中 治疗后CT 喉癌： 光动力治疗 治疗前　　　　　　　　 治疗后 治疗后48h 治疗前 治疗后5个月 治疗后5天 肛周湿疹样癌：光动力治疗 PDT的特点 安全性好、损伤轻、痛苦少 器官结构完整、生理功能正常 技术与设备相对简单 对于综合治疗是有力的补充与配合 PDT的综合治疗 热疗 化疗 放疗 外科手术治疗 免疫治疗 激光治疗 前景展望 根治早期癌有潜力，符合21世纪肿瘤医学的发展方向 晚期癌姑息治疗的应用广阔 向多种光敏剂、多种波长、规范化、个体化治疗的方向发展 发展多学科、多种手段的综合治疗 拓展非肿瘤性疾病的光动力治疗 符合百姓需要和国情特点，适于提高与普及 许多国家已正式批准 Good bye * Notes: The second stage of PDT with PHOTOFRIN? 40 to 50 hours after PHOTOFRIN? injection, is the photoactivation of PHOTOFRIN? via illumination with laser light. PHOTOFRIN? is activated by visible, nonthermal light at a 630 nm wavelength, delivered to the tumor by OPTIGUIDE? cylindrical fiber optic diffusers passed through the operating channel of an endoscope The endoscopic delivery of light to activate PHOTOFRIN? is similar to routine esophageal endoscopy. Because the activating light is nonthermal, high intrathoracic temperatures are not generated1 A second laser light application may be given 96 to 120 hours after injection, on Day 5, preceded by gentle debridement of residual tumor. No further injection of PHOTOFRIN? is given for this retreatment2 Patients may receive a second course of PDT with PHOTOFRIN? a minimum of 30 days after the initial therapy; up to three courses of PDT (each separated by a minimum of 30 days) can be given. Before each course of treatment, patients should be evaluated for the presence of tracheoesophageal or bronchoesophageal fistula2 1. Heier SK. Photodynamic therapy for esophageal malignancies. In: Barkin JS, O’Phelan CA, eds. Advanced Therapeutic Endoscopy. 2nd ed. New York, NY: Raven Press; 1994:57-65. 2. PHOTOFRIN? Prescribing Information. * The ideal oncologic therapy must be effective at a reasonable physical “cost” to the patient. PDT offers many advantages over other standard treatments, such as surgical resection, radiation and chemotherapy. Surgery is the treatme