About-cancer / kurapwa / mhando / kuvhiya / photodynamic-chokwadi-sheet
Zviri Mukati
Photodynamic Therapy yeCancer
Chii chinonzi Photodynamic Therapy?
Photodynamic therapy (PDT) kurapwa kunoshandisa mushonga, unonzi photosensitizer kana photosensitizing mumiriri, uye nerumwe rudzi rwechiedza. Kana photosensitizers akafumurwa kune yakasarudzika wavelength yechiedza, ivo vanogadzira fomu yeoksijeni inouraya masero ari padyo (1 ?? 3).
Imwe neimwe photosensitizer inogoneswa nechiedza cheiyo chaiyo wavelength (3, 4). Iyi wavelength inosarudza kuti mwenje unokwanisa kufamba kusvika sei mumuviri (3, 5). Nekudaro, vanachiremba vanoshandisa chaiwo photosensitizers uye wavelengths yechiedza kurapa nzvimbo dzakasiyana dzemuviri ne PDT.
PDT inoshandiswa sei kurapa cancer?
Padanho rekutanga re PDT yekurapa kenza, photosensitizing mumiririri inojowa muropa. Mumiriri anodhonzwa nemasero muviri wese asi anogara mumasero ekenza kwenguva yakareba kupfuura zvaanoita mumasero akajairwa. Anenge maawa makumi maviri nemana kusvika makumi manomwe nemaviri mushure mejekiseni (1), apo vazhinji mumiririri vasiya masero akajairika asi vachiramba vari mumasero ekenza, bundu rinoburitswa muchiedza. Iyo photosensitizer mune bundu inobata mwenje uye inogadzira inoshanda fomu yemo oxygen iyo inoparadza iri padyo maseru ekenza (1 ?? 3).
Pamusoro pekuuraya zvakananga maseru ekenza, PDT inoita kunge inodzikira kana kuparadza mamota mune dzimwe nzira mbiri (1 ?? 4). Iyo photosensitizer inogona kukuvadza tsinga dzeropa mubundu, nokudaro ichidzivirira kenza kubva pakuwana zvinovaka muviri zvinodiwa. PDT zvakare inogona kumutsa immune system kurwisa mamota maseru.
Chiedza chinoshandiswa PDT chinogona kubva kune laser kana zvimwe zvinyorwa (2, 5). Laser mwenje inogona kutungamirwa kuburikidza ne fiber optic tambo (dzakatetepa tambo dzinoendesa mwenje) kuendesa mwenje kunzvimbo dziri mukati memuviri (2). Semuenzaniso, iyo fiber optic tambo inogona kuiswa kuburikidza ne endoscope (yakatetepa, yakavhenekerwa chubhu inoshandiswa kutarisa matishu mukati memuviri) mumapapu kana esophagus yekurapa kenza munhengo idzi. Zvimwe zvinopihwa mwenje zvinosanganisira mwenje unoburitsa mwenje (maOD), ayo anogona kushandiswa kumamota epasi, senge kenza yeganda (5).
PDT inowanzoitwa seanorapa maitiro (6). PDT inogona zvakare kudzokororwa uye inogona kushandiswa nemamwe marapirwo, sekuvhiya, radiation radiation, kana chemotherapy (2).
Extracorporeal photopheresis (ECP) imhando yePDT umo muchina unoshandiswa kutora masero eropa emurwere, woarapa kunze kwemuviri neanoshanda photosensitizing, anovaisa pachiedza, wozoadzosera kumurwere. IU.S. Chikafu neDrug Administration (FDA) yakabvumidza ECP kubatsira kudzikisira kuomarara kwezviratidzo zveganda zveT-cell lymphoma isina kuchembera isina kupindura kune mamwe marapirwo. Zvidzidzo zviri kuenderera mberi kuona kana ECP inogona kunge iine kumwe kunyorera kweimwe kanzira yeropa, uye zvakare kubatsira kudzikisa kurambwa mushure mekuiswazve.
Ndeapi marudzi ekenza arapwa iye zvino ne PDT?
Parizvino, iyo FDA yakabvumidza iyo photosensitizing mumiriri inonzi porfimer sodium, kana Photofrin®, kuti ishandiswe muPDT kurapa kana kubvisa zviratidzo zvegomarara reesophageal uye isina-diki kenza yemapapu kenza. Porfimer sodium inogamuchirwa kubvisa zviratidzo zvegomarara rekuzvimba apo gomarara rinodzivirira ezophagus kana kana gomarara risingakwanise kurapwa zvinogutsa ne laser therapy chete. Porfimer sodium inoshandiswa kurapa isiri-diki kenza yemapapu yemapapu muvarwere avo marapirwo akajairwa asina kukodzera, uye kubvisa zviratidzo kune varwere vane isiri-diki kenza yemapapu yemapapu inotadzisa iyo nzira yemhepo. Muna 2003, FDA yakabvumira porfimer sodium yekurapa zvipembenene zvinotapukira kune varwere vane Barrett esophagus, mamiriro anogona kutungamira kukenza esophageal.
Ndezvipi zvinokanganisa PDT?
Chiedza chinodiwa kuti chigadzire mafotoensitizers mazhinji haapfuure anopfuura chinenge chetatu cheasendimita yetishu (1 sentimita). Nechikonzero ichi, PDT inowanzo shandiswa kurapa mamota kana kana pasi peganda chete kana pamutsara wenhengo dzemukati kana mhango (3). PDT haina kunyanyo shanda pakurapa mamota makuru, nekuti mwenje haugone kupfuura kure kune aya mamota (2, 3, 6). PDT kurapwa kwenzvimbo uye kazhinji hakugone kushandiswa kurapa kenza yakapararira (metastasized) (6).
PDT ine chero zvinetswa kana mhedzisiro here?
Porfimer sodium inoita kuti ganda nemaziso zvinyatso kujeka kwechiedza kweanenge mavhiki matanhatu mushure mekurapwa (1, 3, 6). Nekudaro, varwere vanorayirwa kuti vadzivise zuva rakananga uye kupenya kwemwenje kwemukati kweanenge mavhiki matanhatu.
Photosensitizers inowanzo kuvaka mumamota uye mwenje unoshanda unotarisa pane bundu. Nekuda kweizvozvo, kukuvara kumaturu ane hutano kushoma. Nekudaro, PDT inogona kukonzeresa kutsva, kuzvimba, kurwadziwa, uye kupora muzvipenga zvine hutano zviri pedyo (3). Mimwe mhedzisiro mhedzisiro yePDT inoenderana nenzvimbo inorapwa. Zvinogona kusanganisira kukosora, kunetseka kumedza, kurwadziwa nemudumbu, kufema kunorwadza, kana kufema kwekufema; izvi zvinokanganisa kazhinji ndezvenguva pfupi.
Chii chine ramangwana rakabata PDT?
Vatsvagiri vanoramba vachidzidza nzira dzekuvandudza kushanda kwePDT uye kuiwedzera kune mamwe kanzira. Zvirwere zvemakiriniki (zvidzidzo zvekutsvaga) zviri kuitiswa kuongorora mashandisirwo ePDT emakenza europi, ganda, prostate, chibereko, uye peritoneal cavity (nzvimbo iri mudumbu ine ura, mudumbu, uye chiropa). Kumwe kutsvagisa kwakanangana nekuvandudzwa kwefotosensitizers iyo ine simba rakanyanya (1), inonyatso tarisa maseru ekenza (1, 3, 5), uye anogoneswa nechiedza chinokwanisa kupinda munyama nekurapa mamota akadzika kana makuru (2). Vatsvagiri vari kuongororawo nzira dzekuvandudza michina (1) uye kuunzwa kwechiedza chinoshanda (5).
Sarudzo Referensi
- Dolmans DE, Fukumura D, Jain RK. Photodynamic kurapa kwekenza. Zvisikwa Ongororo Cancer 2003; 3 (5): 380-387. [PubMed Abstract]
- Wilson BC. Photodynamic kurapwa kwekenza: misimboti. Canadian Zvinyorwa zveGastroenterology 2002; 16 (6): 393–396. [PubMed Abstract]
- Vrouenraets MB, Visser GW, Snow GB, van Dongen GA. Misimboti misimboti, kunyorera mu oncology uye nekuvandudza kusarudzika kweiyo photodynamic kurapwa. Anticancer Tsvagiridzo 2003; 23 (1B): 505-522. [PubMed Abstract]
- Dougherty TJ, Gomer CJ, Henderson BW, et al. Photodynamic kurapa. Zvinyorwa zveNational Cancer Institute 1998; 90 (12): 889-905. [PubMed Abstract]
- Gudgin Dickson EF, Goyan RL, Pottier RH. Maitiro matsva mune photodynamic kurapwa. Cellular uye Molecular Biology 2002; 48 (8): 939-954. [PubMed Abstract]
- Capella MA, Capella LS. Chiedza mumushonga wemishonga yakawanda: photodynamic kurapwa kwemamota akawanda asingagone kushandisa zvinodhaka. Zvinyorwa zveByomedical Science 2003; 10 (4): 361–366. [PubMed Abstract]
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