光动力治疗早期阴茎癌的体会

V. Kapinus, O. Karyakin, E. V. Yaroslavtseva-Isaeva, O. E. Popovkina, S. A. Ivanov, А. Kaprin
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PDT was performed with preliminary administration of Photolon and Photoran photosensitizers. Laser exposure on the tumor lesions was performed 3 hours after photosensitizer administration using laser device Latus-2 (662 nm), light dose 200–300 J/cm2, power density 0.21–0.41 mW/cm2.Results. After 1 PDT session, full regression was observed in 11 (73.3 %) patients, partial regression in 4 (26.7 %) patients who underwent 2nd session 2 months later with full effect. Therefore, in all patients full regression of the tumors was achieved. Follow-up duration was 6–56 months. Recurrence was diagnosed in 1 (6.7 %) patient 36 months after PDT, 14 (93.3 %) patients are under observation without signs of local recurrence, among them for more than 4 years – 3 men, more than 3 years – 1, more than 2 years – 3, more than 1 year – 4 and more than 6 months – 3. During the follow-up, no regional or distant metastases were observed in any of the patients.Conclusion. 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摘要

背景。阴茎癌是一种罕见的肿瘤病理。由于受影响部位的亲密性和器官对患者心理情绪状态的高度重要性,在疾病的早期阶段,首选保留器官的手术,以尽量减少对患者生活质量的影响,同时不影响肿瘤结果。评价氯E6衍生物光动力疗法治疗早期阴茎癌的疗效。材料和方法。在2017年至2021年期间,使用氯E6衍生物PDT治疗早期阴茎癌的患者为15例,年龄在29至84岁之间(平均年龄56.4岁)。肿瘤分期为Tin - 1bn0m0。PDT是在初步使用Photolon和Photoran光敏剂的情况下进行的。使用激光装置Latus-2 (662 nm),光剂量200 ~ 300 J/cm2,功率密度0.21 ~ 0.41 mW/cm2,光敏剂给药后3小时对肿瘤病变进行激光照射。1次PDT治疗后,11例(73.3%)患者完全消退,4例(26.7%)患者部分消退,2个月后进行第2次PDT治疗,效果完全。因此,所有患者的肿瘤均完全消退。随访时间6 ~ 56个月。1例(6.7%)患者在PDT后36个月诊断出复发,14例(93.3%)患者在观察中无局部复发迹象,其中4年以上3例,3年以上1例,2年以上3例,1年以上4例,6个月以上3例。在随访期间,所有患者均未见局部或远处转移。PDT联合氯E6衍生物是一种有效的保留器官的早期阴茎癌治疗方法,肿瘤效果满意,且不影响患者的生活质量。93.3%的患者未见局部复发;随访期间未发现远处转移。需要指出的是,治疗的美容效果令人满意:在所有患者中,形成弹性不变形疤痕,完整保存阴茎解剖结构,PDT后未观察到勃起功能障碍或排尿中断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Experience of using photodynamic therapy in early stages of penile cancer
Background. Penile cancer is a rare oncological pathology. Due to the intimate nature of the affected area and high significance of the organ for psycho-emotional state of the patient, at the early stages of the disease organ-sparing operations are preferred allowing to minimize the effect on patient’s quality of life without affecting oncological results.Aim. To evaluate the effectiveness of treatment of early stages penile cancer using photodynamic therapy (PDT) with chlorin E6 derivatives.Materials and methods. Between 2017 and 2021, PDT with chlorin E6 derivatives to treat early-stage penile cancer was performed in 15 patients between the ages of 29 and 84 years (mean age 56.4 years). Tumor stage was Tin situ–1bN0M0. PDT was performed with preliminary administration of Photolon and Photoran photosensitizers. Laser exposure on the tumor lesions was performed 3 hours after photosensitizer administration using laser device Latus-2 (662 nm), light dose 200–300 J/cm2, power density 0.21–0.41 mW/cm2.Results. After 1 PDT session, full regression was observed in 11 (73.3 %) patients, partial regression in 4 (26.7 %) patients who underwent 2nd session 2 months later with full effect. Therefore, in all patients full regression of the tumors was achieved. Follow-up duration was 6–56 months. Recurrence was diagnosed in 1 (6.7 %) patient 36 months after PDT, 14 (93.3 %) patients are under observation without signs of local recurrence, among them for more than 4 years – 3 men, more than 3 years – 1, more than 2 years – 3, more than 1 year – 4 and more than 6 months – 3. During the follow-up, no regional or distant metastases were observed in any of the patients.Conclusion. PDT with chlorin E6 derivatives is an effective organ-sparing treatment method for early-stage penile cancer with satisfactory oncological results without negative effect on patients’ quality of life. In 93.3 % of patients, local recurrence of the disease was not observed; during follow-up no distant metastases were diagnosed. It is necessary to point out satisfactory cosmetic results of the treatment: in all patients, elastic non-deforming scars were formed with full preservation of anatomical structures of the penis, no erectile dysfunction or disruption of urination were observed after PDT.
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