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Chlorin e6-polyvinylpyrrolidone mediated photodynamic therapy-A potential bladder sparing option for high risk non-muscle invasive bladder cancer

机译：氯霉素e6-聚乙烯吡咯烷酮介导的光动力疗法-高危非肌肉浸润性膀胱癌的潜在膀胱保留选择

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摘要

Background: Bladder sparing treatment options for high risk non-muscle invasive blader cancer (NMIBC) after intravesical Bacillus Calmette-Guerin (BCG) failure are limited. Objective: To evaluate photodynamic therapy (PDT) using chlorin e6-polyvinylpyrrolidone (Ce6-PVP) as a bladder sparing therapy for NMIBC refractory to intravesical BCG therapy. Materials and methods: Between July 2004 and June 2009, patients with recurrent NMIBC after induction intravesical BCG therapy were treated with PDT performed with a 665 nm laser and light dosimetry of 10-24 J/cm~2. The patients underwent cystoscopic surveillance for tumour recurrence post PDT. Post treatment lower urinary tract symptoms and bladder capacity were also monitored. Serum and urine samples were collected for spectrometric quantification of photosensitizer levels. Results: Five patients underwent PDT, with a total of seven treatments performed. One patient received intravenous Ce6-PVP, while the rest received intravesical Ce6-PVP.The median age was 80 years (mean 79 years, range 72-88 years). There were three patients with primary CIS of the bladder and two with T1 high grade TCC and CIS of the bladder. At a median follow-up of 29 months (mean 25 months, range 6-36 months), two patients were disease free, two patients developed recurrence and one patient progressed to muscle invasive disease. There were no immediate adverse effects. The patient receiving intravenous Ce6-PVP developed an enterovesical fistula 16 months post PDT. Conclusions: Despite being a small pilot study, intravesical Ce6-PVP mediated PDT is a feasible bladder sparing treatment option for recurrent high risk non-muscle invasive bladder carcinoma in selected individuals.
机译：背景：膀胱内Bacillus Calmette-Guerin（BCG）衰竭后，高危非肌肉浸润性刀刃癌（NMIBC）的膀胱保留疗法选择有限。目的：评价使用二氢卟酚e6-聚乙烯吡咯烷酮（Ce6-PVP）作为膀胱保留疗法治疗难治性膀胱内BCG的NMIBC的光动力疗法（PDT）。材料与方法：2004年7月至2009年6月，对接受NBCBC诱导的膀胱内BCG治疗后复发的NMIBC患者进行665 nm激光的PDT和10-24 J / cm〜2的剂量测定。患者在PDT后接受了膀胱镜检查以检查是否有肿瘤复发。治疗后还监测下尿路症状和膀胱容量。收集血清和尿液样品用于光敏剂水平的光谱定量。结果：5例患者接受了PDT，总共进行了7种治疗。 1例患者接受静脉Ce6-PVP治疗，其余患者接受膀胱内Ce6-PVP治疗。中位年龄为80岁（平均79岁，范围72-88岁）。有3例膀胱原发性CIS和2例T1高级TCC和膀胱CIS。在中位随访期29个月（平均25个月，范围6-36个月）中，两名患者没有疾病，两名患者复发，一名患者进展为肌肉浸润性疾病。没有立即的不良影响。 PDT后16个月接受静脉Ce6-PVP的患者出现了肠瘘。结论：尽管是一项小型的前期研究，但膀胱内Ce6-PVP介导的PDT对于某些个体复发性高风险非肌肉浸润性膀胱癌是可行的保留膀胱的治疗选择。

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  • 来源
    《Photodiagnosis and Photodynamic Therapy》 |2010年第4期|p.213-220|共8页
  • 作者

    Lui Shiong Lee; Patricia Soo PingThong; Malini Olivo; William Wei Lim Chin; Bhuvaneswari Ramaswamy; Kiang Wei Kho; Pei Li Lim; Weber Kam On Lau;

  • 作者单位

    Department of Urology, Singapore General Hospital, Outram Road, 169608, Singapore;

    Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, 169610, Singapore;

    Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, 169610, Singapore,Singapore Bioimaging Consortium, Biomedical Sciences Institutes, 11 Biopolis Way, 138667, Singapore,School of Physics, National University of Ireland Galway, Galway, Ireland,Department of Pharmacy, National University of Singapore, Science Drive 4, Block S4, 117543, Singapore;

    Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, 169610, Singapore;

    Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, 169610, Singapore;

    Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, 169610, Singapore;

    Department of Urology, Singapore General Hospital, Outram Road, 169608, Singapore;

    Department of Urology, Singapore General Hospital, Outram Road, 169608, Singapore;

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  • 正文语种 eng
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  • 关键词

    photodynamic therapy; photosensitizers; lasers; bladder cancer;

    机译：光动力疗法;光敏剂;激光膀胱癌;

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