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Clinical application of the mirror irradiation technique in photodynamic therapy for malignant glioma

机译：镜辐射技术在恶性胶质瘤光动力治疗中的临床应用

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Background: Intraoperative photodynamic therapy (PDT) using talaporfin sodium for malignant glioma is effective both in the experimental and in the clinical setting. Because the irradiation unit is fixed to the objective lens of the operating microscope, blind spots for irradiation exist. To overcome this problem, we developed a mirror reflecting system using a modified dental mirror.Methods: The developed mirror is made of stainless steel, has a mirror-polished surface, and is rhodium coated on 1 side, which is the reflecting surface. The reflection rate was measured using He-Ne laser irradiation. The reflection intensity was measured using a laser power meter when the incident angle to the mirror was changed to 60 degrees, 45 degrees, and 30 degrees, and the reflectance was calculated by the direct received light intensity from the laser. After confirming the safety of the fundamental experiment, PDT was performed with this developed mirror on 9 patients with malignant glioma (4 with recurrence and 5 newly diagnosed).Results: The energy efficiency of the mirror was approximately 70 %, and apparent irregular reflection was not observed. Even during clinical use, apparent complications, such as irregular reflection, did not occur upon using the mirror in any of the patients. In all patients, recurrence did not occur in the site where mirror irradiation was performed, but in a deep site or a distant site to which sufficient laser irradiation did not reach.Conclusion: PDT using our newly developed mirror involves few instrumental changes compared with the conventional irradiation method, and is effective, safe, and inexpensive.
机译：背景：使用Talaporfin Sodium用于恶性胶质瘤的术中光动力学治疗（PDT）在实验和临床环境中是有效的。因为照射单元固定到操作显微镜的物镜，所以存在盲斑。为了克服这个问题，我们开发了一种使用改进的牙科镜的镜面反射系统。方法：开发的镜子由不锈钢制成，具有镜面抛光表面，并且是镀铑，涂上1侧，这是反射表面。使用HE-NE激光辐射测量反射率。当与镜子的入射角改变为60度，45度和30度时，使用激光功率计测量反射强度，并且通过来自激光的直接接收的光强度计算反射率。在确认基本实验的安全后，PDT在9例恶性胶质瘤患者（4患者和5新诊断）的情况下进行PDT进行。结果：镜子的能效约为70％，并且表观不规则反射是未观察到。即使在临床使用期间，在任何患者中使用镜子时也不会发生表观并发症，例如不规则反射。在所有患者中，在进行镜像辐射的位置，但在镜像辐射的遗址中没有发生复发，但在一个深处的激光照射没有达到的远处部位。结论：使用我们的新开发的镜子的PDT涉及与...相比很少有乐器变化常规辐射法，是有效，安全，廉价的。

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