Ibyerekeye-kanseri / kuvura / ubwoko / kubaga / gufotora-gufotora
Ibirimo
Ubuvuzi bwa Photodynamic kuri Kanseri
Ubuvuzi bwa Photodynamic ni ubuhe?
Ubuvuzi bwa Photodynamic (PDT) nubuvuzi bukoresha ibiyobyabwenge, byitwa fotosensizer cyangwa agent fotensensizing, nubwoko bwurumuri. Iyo fotosensiseri ihuye nuburebure bwumucyo wihariye, itanga uburyo bwa ogisijeni yica selile zegeranye (1 ?? 3).
Buri fotosensitizer ikorwa nurumuri rwumurongo wihariye (3, 4). Ubu burebure bwerekana intera urumuri rushobora kugera mumubiri (3, 5). Kubwibyo, abaganga bakoresha amafoto yihariye hamwe nuburebure bwumucyo kugirango bavure ibice bitandukanye byumubiri hamwe na PDT.
Nigute PDT ikoreshwa mu kuvura kanseri?
Mu ntambwe yambere ya PDT yo kuvura kanseri, agent yifotora yatewe mumaraso. Umukozi yakirwa na selile umubiri wose ariko akaguma muri kanseri ya kanseri igihe kirekire kuruta uko iba muri selile zisanzwe. Hafi yamasaha 24 kugeza kuri 72 nyuma yo guterwa inshinge (1), mugihe benshi mubakozi basize selile zisanzwe ariko bakaguma mumasemburo ya kanseri, ikibyimba gihura numucyo. Photosensitizer mu kibyimba ikurura urumuri kandi ikabyara uburyo bukomeye bwa ogisijeni yangiza kanseri ya kanseri iri hafi (1 ?? 3).
Usibye kwica kanseri ya kanseri itaziguye, PDT isa nkigabanuka cyangwa isenya ibibyimba muburyo bubiri (1 ?? 4). Photensitizer irashobora kwangiza imiyoboro y'amaraso mu kibyimba, bityo ikarinda kanseri kwakira intungamubiri zikenewe. PDT irashobora kandi gukora sisitemu yumubiri kugirango yibasire selile.
Umucyo ukoreshwa kuri PDT urashobora kuva muri laser cyangwa izindi nkomoko (2, 5). Urumuri rwa lazeri rushobora kwerekanwa hifashishijwe insinga za fibre optique (fibre yoroheje yohereza urumuri) kugirango itange urumuri mubice byumubiri (2). Kurugero, insinga ya fibre optique irashobora kwinjizwa binyuze muri endoskopi (umuyoboro woroheje, urumuri ukoreshwa mu kureba ingirangingo ziri mu mubiri) mu bihaha cyangwa muri esofagusi kuvura kanseri muri izi ngingo. Andi masoko yumucyo arimo diode itanga urumuri (LED), zishobora gukoreshwa mubibyimba byo hejuru, nka kanseri y'uruhu (5).
Ubusanzwe PDT ikorwa nkuburyo bwo kuvura indwara (6). PDT irashobora kandi gusubirwamo kandi irashobora gukoreshwa hamwe nubundi buvuzi, nko kubaga, kuvura imirasire, cyangwa chimiotherapie (2).
Extracorporeal Photopheresis (ECP) ni ubwoko bwa PDT aho imashini ikoreshwa mu gukusanya uturemangingo tw'amaraso tw’umurwayi, tukayivura hanze y’umubiri hamwe n’umukozi wifotora, ikabashyira ku mucyo, hanyuma ikabasubiza umurwayi. Ikigo cy’Amerika gishinzwe ibiryo n’ibiyobyabwenge (FDA) cyemeje ECP gufasha kugabanya ubukana bwibimenyetso byuruhu rwa lymphoma ya T-selile ititabira ubundi buvuzi. Ubushakashatsi burimo gukorwa kugirango hamenyekane niba ECP ishobora kuba ifite izindi kanseri zamaraso, kandi ikanafasha kugabanya kwangwa nyuma yo guterwa.
Ni ubuhe bwoko bwa kanseri buvurwa na PDT?
Kugeza ubu, FDA yemeye umukozi wo gufotora witwa porfimer sodium, cyangwa Photofrin®, kugirango akoreshwe muri PDT mu kuvura cyangwa kugabanya ibimenyetso bya kanseri yo mu nda na kanseri y'ibihaha itari nto. Sodium ya Porfimer yemerewe kugabanya ibimenyetso bya kanseri yo mu nda iyo kanseri ibuza esofagusi cyangwa iyo kanseri idashobora kuvurwa neza hakoreshejwe imiti yonyine. Sodium ya Porfimer ikoreshwa mu kuvura kanseri y'ibihaha itari ntoya ku barwayi badafite imiti isanzwe idakwiye, no kugabanya ibimenyetso ku barwayi barwaye kanseri y'ibihaha itari ntoya ibuza guhumeka. Mu 2003, FDA yemeye sodium ya porfimer yo kuvura ibikomere byanduye ku barwayi barwaye Barrett esophagus, indwara ishobora gutera kanseri yo mu nda.
Ni izihe mbogamizi za PDT?
Umucyo ukenewe kugirango ukoreshe amafoto menshi ntashobora kunyura hejuru ya kimwe cya gatatu cya santimetero imwe (santimetero 1). Kubera iyo mpamvu, ubusanzwe PDT ikoreshwa mukuvura ibibyimba hejuru yuruhu cyangwa munsi yuruhu cyangwa kumurongo wimbere cyangwa mumyanya (3). PDT nayo ntigikora neza mukuvura ibibyimba binini, kubera ko urumuri rudashobora kunyura kure muri ibyo bibyimba (2, 3, 6). PDT ni ubuvuzi bwaho kandi muri rusange ntibushobora gukoreshwa mu kuvura kanseri yakwirakwijwe (metastasize) (6).
PDT ifite ibibazo cyangwa ingaruka mbi?
Sodium ya Porfimer ituma uruhu n'amaso byumva urumuri hafi ibyumweru 6 nyuma yo kuvurwa (1, 3, 6). Niyo mpamvu, abarwayi basabwa kwirinda urumuri rwizuba n’urumuri rwo mu nzu byibuze ibyumweru 6.
Photosensitizer ikunda kwiyongera mubibyimba kandi urumuri rukora rwibanda kumibyimba. Nkigisubizo, kwangirika kwinyama nzima ni bike. Ariko, PDT irashobora gutera inkongi y'umuriro, kubyimba, kubabara, no gukomeretsa mu ngingo zifite ubuzima bwiza (3) Izindi ngaruka za PDT zifitanye isano nakarere kavuwe. Bashobora kubamo gukorora, ikibazo cyo kumira, kubabara mu gifu, guhumeka neza, cyangwa guhumeka neza; izi ngaruka mbi mubisanzwe nigihe gito.
Niki kizaza kuri PDT?
Abashakashatsi bakomeje kwiga uburyo bwo kunoza imikorere ya PDT no kuyagura izindi kanseri. Igeragezwa rya Clinical (ubushakashatsi bwubushakashatsi) ririmo gukorwa kugirango harebwe ikoreshwa rya PDT kuri kanseri yubwonko, uruhu, prostate, cervix, na cavit peritoneal (umwanya uri munda urimo amara, igifu, numwijima). Ubundi bushakashatsi bwibanze ku iterambere ry’amafoto afite imbaraga (1), cyane cyane yibasira kanseri ya kanseri (1, 3, 5), kandi agakorwa n’umucyo ushobora kwinjira mu ngingo no kuvura ibibyimba byimbitse cyangwa binini (2). Abashakashatsi barimo gukora iperereza ku buryo bwo kunoza ibikoresho (1) no gutanga urumuri rukora (5).
Ibyatoranijwe
- Dolmans DE, Fukumura D, Jain RK. Ubuvuzi bwa Photodynamic kuri kanseri. Kamere Isuzuma Kanseri 2003; 3 (5): 380–387. [PubMed]
- Wilson BC. Ubuvuzi bwa Photodynamic kuri kanseri: amahame. Ikinyamakuru cyo muri Kanada cya Gastroenterology 2002; 16 (6): 393–396. [PubMed]
- Vrouenraets MB, Visser GW, Urubura GB, van Dongen GA. Amahame shingiro, ikoreshwa muri oncologiya no kunoza uburyo bwo guhitamo imiti ifotora. Ubushakashatsi bwa Anticancer 2003; 23 (1B): 505–522. [PubMed]
- Dougherty TJ, Gomer CJ, Henderson BW, n'abandi. Ubuvuzi bwa Photodynamic. Ikinyamakuru cy'ikigo cy'igihugu gishinzwe kanseri 1998; 90 (12): 889–905. [PubMed]
- Gudgin Dickson EF, Goyan RL, Pottier RH. Icyerekezo gishya mubuvuzi bwa fotodinamike. Ibinyabuzima bya selile na molekuline 2002; 48 (8): 939–954. [PubMed]
- Capella MA, Capella LS. Umucyo mukurwanya multidrug: kuvura Photodynamic kuvura ibibyimba birwanya imiti myinshi. Ikinyamakuru cya siyansi y’ibinyabuzima 2003; 10 (4): 361–366. [PubMed]
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