Evaluation of photodynamic therapy of skin cancers with δ-aminolevulinic acid  

δ-氨基酮戊酸光动力治疗皮肤癌的评估(英文)

作　　者：徐世正[1] 王秀丽[1] 徐威[1] 夏育民[1] 张春荣[1] 

机构地区：[1]武汉大学人民医院皮肤科,武汉430060

出　　处：《Chinese Medical Journal》2002年第8期1141-1145,共5页中华医学杂志（英文版）

摘　　要：Objective To use δ-aminolevulinic acid induced photodynamic therapy (ALA-PDT) increasingly in treating skin cancers and other diseases in many countries and to explore the efficacy of ALA-PDT for skin cancers in China. Methods Eighty-eight patients, including 34 cases of basal cell carcinoma (BCC), 32 cases of squamous cell carcinoma (SCC), two cases of basal-squamous cell carcinoma (BSCC), one case of verrucuous carcinoma, nine cases of Bowen disease, two cases Paget disease of the nipple and eight cases of extramammary Paget disease, were treated by the δ-aminolevulinic acid induced photodynamic therapy first in China from 1997 to 2000. Results All BCC, including 11 cases of superficial lesions and 29 solid lesions, achieved complete reaction (CR) by 1-4 times of the ALA-PDT. Except one patient with adenoid SCC (grade Ⅲ), all SCC (grade Ⅰ and grade Ⅱ) patients achieved complete remission by 3-6 times of ALA-PDT. All Bowen diseases achieved complete reaction by 1-4 times. Although for Paget diseases it could not cure the disease simply by ALA-PDT, it could control the symptoms. The recurrence rates were 11% (4/34) for BCC, and 22% (7/32) for SCC by following up 1-3 years after the therapy. The continuous therapy is still effective. Conclusions ALA-PDT is an effective, non-traumatic treatment for patients with BCC, SCC, Bowen and Paget diseases. It is especially suitable for older and weaker patients or those who are not tolerable to other therapies. It also has a unique advantage for tumors in specific anatomical areas. It is a new alternative modality for skin cancer therapies.目的　近年来 ,许多国家日益广泛地将δ 氨基酮戊酸光动力疗法 (ALA PDT)用于治疗皮肤癌和其它疾病。本研究的目的是探讨和评估ALA PDT在中国治疗皮肤癌的疗效。方法　共有 88例患者于 1997- 2 0 0 0年间在我院首次接受ALA PDT治疗 ,其中包括 34例基底细胞癌 (BCC) ,32例鳞状细胞癌 (SCC) ,2例基底 鳞状细胞癌 (BSCC) ,1例疣状癌 ,9例Bowen病 ,2例乳房Paget病和 8例乳房外Paget病。随访时间为 1- 3年。结果　经过 1- 4次ALA光动力治疗后 ,所有BCC病例 ,包括 11例浅表型和 2 9例实体型病变 ,都获得痊愈 (CR)。全部SCC病例 (Ⅰ、Ⅱ级 )经过 3- 6次ALA PDT治疗后完全消退 ,只有 1例腺样SCC(Ⅲ级 )除外。接受 1- 4次治疗后 ,所有Bowen病的病例都获得完全缓解。对于Paget病 ,虽然单纯依靠ALA PDT不能使之治愈 ,但可以控制其症状。随访 1- 3年 ,BCC的复发率为 11% (4/34) ,SCC为 2 2 % (7/2 2 ) ,再次治疗有效。结论　ALA PDT对于BCC、SCC、Bowen病和Paget病患者来说 ,是一种疗效好、无创伤性、无副作用的治疗手段 ,患者有很好的耐受性 ,尤其适用于对其它疗法不能耐受、年龄太大和体弱的患者 ,以及肿瘤发生部位特殊的患者。

关 键 词：aminolevulinic acid   photodynamic therapy  · basal cell carcinoma ·  squamous cell carcinoma  ·   basal-squamous cell carcinoma  ·  verrucuou s carcinoma · Bowen disease · Paget disease 

分 类 号：R739.5[医药卫生—肿瘤]