口腔黏膜白斑病的光动力疗法:223 名患者的使用经验

Q3 Medicine
T. Artsemyeva, D. Tzerkovsky
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引用次数: 0

摘要

本研究旨在分析对口腔黏膜白斑病患者使用光动力疗法(PDT)的近期和远期效果。这项回顾性研究包括 223 名经形态学验证的口腔黏膜白斑病患者。患者于 2013 年至 2023 年期间在热疗和光动力疗法科接受了治疗。平均年龄为(51.9±8.9)岁。临床上,211 名患者(94.6%)为扁平型口腔黏膜白斑,12 名患者(5.4%)为疣状口腔黏膜白斑。光敏剂(PS)基于氯素 e6,静脉注射一次,剂量为 1.7 至 2.5 毫克/千克体重。输注结束后 2-2.5 小时,使用波长为 λ=665±5 nm 的半导体激光设备 "UPL PDT "对病理变化的病灶进行照射。激光辐射剂量密度为 25 至 100 J/cm²,功率密度为 0.07 至 0.32 W/cm²,一个照射区域的持续时间为 2 至 13.5 分钟,具体取决于其线性尺寸。不良反应的严重程度在治疗后第 1-30 天使用 CTCAE 4.03 量表进行评估。对治疗的即时效果进行了评估,直至 PDT 治疗后 3 个月,并对治疗反应进行了形态学确认。在 PS 输注和照射过程中未观察到严重的不良反应。没有皮肤光毒性症状的报告。在对照组检查中,扁平疣和疣状疣患者在照射 3 个月后,完全消退的比例分别为 97.1%(205 例)和 58.3%(6 例),部分消退的比例分别为 2.9%(7 例)和 25%(3 例)。客观反应率分别为 100%和 83.3%。对患者的观察期从 3 个月到 120 个月不等。(平均 66 个月)。在此期间疾病复发的频率为 9%。部分消退和复发的患者接受了重复的光动力疗法治疗。对于口腔黏膜白斑病患者来说,光导光疗是一种耐受性良好且有效的治疗方法,与治疗这种癌前病变的传统方法相比具有显著优势。这些优势包括:由于 PS 在白斑组织中的选择性蓄积,对病灶周围正常组织的毒性极小;发生严重不良反应的风险较小;可在门诊进行治疗;可对大面积损害进行重复治疗;以及良好的美容效果)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Photodynamic therapy of leukoplakia of the oral mucosa: experience of using method in 223 patients
The aim of this study was to analyze the immediate and long-term results of using photodynamic therapy (PDT) in patients with leukoplakia of the oral mucosa. The retrospective study included 223 patients with morphologically verified leukoplakia of the oral mucosa. Patients received treatment at the hyperthermia and photodynamic therapy department from 2013 to 2023. The average age was 51.9±8.9 years. Clinically, 211 patients (94.6%) had a flat form of the disease, 12 patients (5.4%) had a verrucous form. The photosensitizer (PS), based on chlorin e6, was administered intravenously once in doses of 1.7 to 2.5 mg/kg body weight. Irradiation of pathologically changed lesions was carried out 2-2.5 hours after the end of its infusion, using a semiconductor laser device “UPL PDT”, with a wavelength λ=665±5 nm. The laser radiation dose density varied from 25 to 100 J/cm², the power density from 0.07 to 0.32 W/cm², the duration of one irradiation field - from 2 to 13.5 minutes, depending on its linear dimensions. The severity of adverse reactions was assessed on days 1-30 after treatment using the CTCAE 4.03 scale. The immediate results of treatment were assessed up to 3 months after PDT, with morphological confirmation of the response to treatment. No serious adverse reactions were observed during PS infusion and irradiation. No symptoms of dermal phototoxicity were reported. During control examinations, up to 3 months after irradiation in patients with flat and verrucous forms, the frequency of complete regressions was 97.1% (n=205) and 58.3% (n=6) cases, partial regressions - 2,9% (n=7) and 25% (n=3) of cases, respectively. Objective response rates were observed at 100% and 83.3%, respectively. The period of observation of patients varies from 3 to 120 months. (average 66 months). The frequency of disease relapses during this period was 9%. Patients with partial regression and identified relapse were treated with repeated PDT sessions. PDT is a well-tolerated and effective treatment method for patients with leukoplakia of the oral mucosa, which has significant advantages over traditional methods of treating this precancerous pathology. These include minimal toxicity to the normal tissues surrounding the pathological foci due to the selective accumulation of PS in leukoplakia tissues, a slight risk of serious adverse reactions, the possibility of an outpatient session, the possibility of repeated treatment over a large area of damage and good cosmetic results).
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来源期刊
Biomedical Photonics
Biomedical Photonics Medicine-Surgery
CiteScore
1.80
自引率
0.00%
发文量
19
审稿时长
8 weeks
期刊介绍: The main goal of the journal – to promote the development of Russian biomedical photonics and implementation of its advances into medical practice. The primary objectives: - Presentation of up-to-date results of scientific and in research and scientific and practical (clinical and experimental) activity in the field of biomedical photonics. - Development of united Russian media for integration of knowledge and experience of scientists and practitioners in this field. - Distribution of best practices in laser medicine to regions. - Keeping the clinicians informed about new methods and devices for laser medicine - Approval of investigations of Ph.D candidates and applicants.
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