Pafupifupi-khansa / chithandizo / mitundu / opaleshoni / photodynamic-sheet-sheet
Zamkatimu
Thandizo la Photodynamic la Khansa
Kodi Photodynamic Therapy ndi chiyani?
Photodynamic therapy (PDT) ndi mankhwala omwe amagwiritsa ntchito mankhwala, otchedwa photosensitizer kapena photosensitizing agent, ndi mtundu wina wa kuwala. Ma photosensitizers akakhala ndi kuwala kwina, amapanga oxygen yomwe imapha ma cell apafupi (1 ?? 3).
Photosensitizer iliyonse imayambitsidwa ndi kuwala kwa mawonekedwe ake enieni (3, 4). Kutalikaku kumatsimikizira kutalika komwe kuwala kumatha kulowa mthupi (3, 5). Chifukwa chake, madotolo amagwiritsa ntchito zithunzi zowunikira ndi mawonekedwe a kuwala kuti athetse mbali zosiyanasiyana za thupi ndi PDT.
Kodi PDT imagwiritsidwa ntchito bwanji pochiza khansa?
Pachigawo choyamba cha PDT chothandizira khansa, photosensitizing agent amalowetsedwa m'magazi. Wothandizirayo amalowetsedwa m'maselo mthupi lonse koma amakhala m'maselo a khansa nthawi yayitali kuposa momwe amakhalira m'maselo abwinobwino. Pafupifupi maola 24 mpaka 72 pambuyo pa jakisoni (1), wothandizirayo atasiya maselo abwinobwino koma amakhalabe m'maselo a khansa, chotupacho chimawonekeranso. Photosensitizer mu chotupacho chimatenga kuwala ndikupanga mpweya wabwino womwe umawononga ma cell a khansa oyandikira (1 ?? 3).
Kuphatikiza pakupha mwachindunji ma cell a khansa, PDT ikuwoneka kuti ikuchepa kapena kuwononga zotupa munjira zina ziwiri (1 ?? 4). Photosensitizer imatha kuwononga mitsempha yamagazi pachotupacho, potero imalepheretsa khansa kulandira michere yofunikira. PDT itha kuyambitsanso chitetezo chamthupi kuti chiwononge zotupa.
Kuwala komwe kumagwiritsidwa ntchito kwa PDT kumatha kubwera kuchokera ku laser kapena magwero ena (2, 5). Kuwala kwa Laser kumatha kuwongoleredwa kudzera pazingwe za fiber optic (zingwe zopyapyala zomwe zimafalitsa kuwala) kuti ziunikire kuwala kumadera amkati mwa thupi (2). Mwachitsanzo, chingwe cha fiber optic chitha kulowetsedwa kudzera mu endoscope (chubu chowonda, chowunikira chomwe chimayang'ana minofu mkati mwa thupi) m'mapapu kapena m'mero kuti muchiritse khansa m'matumbawa. Zowunikira zina zimaphatikizira ma diode otulutsa kuwala (ma LED), omwe atha kugwiritsidwa ntchito pazotupa zakumaso, monga khansa yapakhungu (5).
PDT nthawi zambiri imachitidwa ngati njira yothandizira odwala (6). PDT itha kubwerezedwanso ndipo itha kugwiritsidwa ntchito ndi mankhwala ena, monga opaleshoni, radiation radiation, kapena chemotherapy (2).
Extracorporeal photopheresis (ECP) ndi mtundu wa PDT momwe makina amagwiritsidwira ntchito kusonkhanitsa maselo amwazi wa wodwalayo, kuwachiritsa kunja kwa thupi ndi chojambulira cha photosensitizing, kuwayika poyera, kenako kuwabwezera kwa wodwalayo. US Food and Drug Administration (FDA) yavomereza ECP kuti ichepetse kuopsa kwa zizindikilo za khungu la khungu la T-cell lymphoma lomwe silinayankhe kuchipatala china. Kafukufuku ali mkati kuti adziwe ngati ECP itha kukhala ndi ntchito zina za khansa ina yamagazi, komanso kuthandizira kuchepetsa kukanidwa pambuyo pakuziika.
Ndi mitundu iti ya khansa yomwe imathandizidwa ndi PDT?
Mpaka pano, a FDA adavomereza wothandizirana ndi photosensitizing wotchedwa porfimer sodium, kapena Photofrin®, kuti agwiritsidwe ntchito mu PDT kuchiza kapena kuthana ndi zizindikilo za khansa ya esophageal komanso khansa ya m'mapapo yaing'ono. Porfimer sodium imavomerezedwa kuti ichepetse matenda a khansa yotupa m'mimba ngati khansara itsekereza kholingo kapena ngati khansayo singathe kuchiritsidwa moyenera ndi mankhwala a laser okha. Porfimer sodium imagwiritsidwa ntchito pochiza khansa ya m'mapapo yaing'ono yomwe ili yaying'ono kwa odwala omwe mankhwalawa sioyenera, komanso kuti athetse vuto la odwala omwe ali ndi khansa yaying'ono yamapapo yam'mapapo yomwe imalepheretsa kuwuluka. Mu 2003, a FDA adavomereza porfimer sodium yothandizira odwala zotupa m'mimba mwa Barrett esophagus, zomwe zingayambitse khansa ya m'mimba.
Kodi zoperewera za PDT ndi ziti?
Kuwala komwe kumafunikira kuti atsegule zithunziensitizers ambiri sikungadutse pafupifupi gawo limodzi mwa magawo atatu a inchi (1 sentimita). Pachifukwa ichi, PDT imagwiritsidwa ntchito pochizira zotupa mkati kapena pansi pa khungu kapena pakatikati pa ziwalo zamkati kapena minyewa (3). PDT siyothandiza kwambiri pochiza zotupa zazikulu, chifukwa kuwala sikungadutse kufikira zotupa izi (2, 3, 6). PDT ndi mankhwala am'deralo ndipo sangathe kugwiritsidwa ntchito pochiza khansa yomwe yafalikira (metastasized) (6).
Kodi PDT ili ndi zovuta zina kapena zoyipa zilizonse?
Porfimer sodium imapangitsa khungu ndi maso kuzindikira kuwala kwa masabata pafupifupi 6 mutalandira chithandizo (1, 3, 6). Chifukwa chake, odwala amalangizidwa kuti azipewa kuwala kwa dzuwa komanso kuwala kwa nyumba kwa milungu isanu ndi umodzi.
Photosensitizers amakonda kumangika mu zotupa ndipo kuwala komwe kumayang'ana kumayang'ana pachotupacho. Zotsatira zake, kuwonongeka kwa minofu yathanzi kumakhala kochepa. Komabe, PDT imatha kuyambitsa zilonda zam'mimba, kutupa, kupweteka, ndi mabala m'matumba athanzi apafupi (3). Zotsatira zina za PDT ndizokhudzana ndi dera lomwe amachiritsidwa. Zitha kuphatikizira kutsokomola, kuvuta kumeza, kupweteka m'mimba, kupuma kowawa, kapena kupuma movutikira; zotsatirazi nthawi zambiri zimakhala zosakhalitsa.
Kodi tsogolo la PDT ndilotani?
Ofufuzawo akupitiliza kuphunzira njira zowonjezeretsa mphamvu za PDT ndikuziwonjezera ku khansa zina. Mayeso azachipatala (kafukufuku) akuyamba kuwunika momwe PDT imagwiritsira ntchito khansa yaubongo, khungu, prostate, khomo pachibelekeropo, ndi peritoneal cavity (danga m'mimba lomwe muli matumbo, m'mimba, ndi chiwindi). Kafufuzidwe kena kakuyang'ana pakupanga kwa photosensitizers omwe ali amphamvu kwambiri (1), omwe amawunikira makamaka ma cell a khansa (1, 3, 5), ndipo amayatsidwa ndi kuwala komwe kumatha kulowa minyewa ndikuchiza zotupa zakuya kapena zazikulu (2). Ofufuzawa akufufuzanso njira zowonjezeretsa zida (1) ndikuperekera kwa magetsi (5).
Zolemba Zosankhidwa
- Ma Dolmans DE, Fukumura D, Jain RK. Thandizo la Photodynamic la khansa. Khansa Yachilengedwe 2003; 3 (5): 380–387. [Adasankhidwa]
- Wilson BC. Thandizo la Photodynamic la khansa: mfundo. Canadian Journal ya Gastroenterology 2002; 16 (6): 393–396. [Adasankhidwa]
- Vrouenraets MB, Visser GW, Snow GB, van Dongen GA. Mfundo zoyambira, kugwiritsa ntchito oncology ndikusankha kwamankhwala othandizira mphamvu zamagetsi. Kafukufuku wa Anticancer 2003; 23 (1B): 505-522. [Adasankhidwa]
- Dougherty TJ, Gomer CJ, Henderson BW, ndi al. Thandizo la Photodynamic. Zolemba pa National Cancer Institute 1998; 90 (12): 889–905. [Adasankhidwa]
- Gudgin Dickson EF, Goyan RL, Pottier RH. Mayendedwe atsopano mu mankhwala a photodynamic. Ma Biology ndi Ma Cellular 2002; 48 (8): 939-954. [Adasankhidwa]
- Capella MA, Capella LS. Kuwala kwa kukana kwamankhwala ambiri: chithandizo cha photodynamic cha zotupa zosagwirizana ndi mankhwala. Zolemba za Biomedical Science 2003; 10 (4): 361-366. [Adasankhidwa]
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