Mabapi le kankere / kalafo / mefuta / opereishene / photodynamic-sheet-sheet
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Phekolo ea Photodynamic bakeng sa Kankere
Therapy ea Photodynamic ke eng?
Photodynamic Therapy (PDT) ke kalafo e sebelisang sethethefatsi, se bitsoang photosensitizer kapa photosensitizing agent, le mofuta o itseng oa khanya. Ha li-photosensitizers li pepesehela bokahohle bo itseng ba khanya, li hlahisa mofuta oa oksijene o bolaeang lisele tse haufi (1 ?? 3).
Setšoantšo se seng le se seng sa photosensitizer se sebelisoa ka leseli la bokahohle bo itseng (3, 4). Bolelele bona ba bokahohle bo lekanya hore na leseli le ka tsamaea 'meleng o kae (3, 5). Kahoo, lingaka li sebelisa li-photosensitizers tse khethehileng le bolelele ba bolelele ba khanya ho alafa likarolo tse fapaneng tsa 'mele ka PDT.
PDT e sebelisoa joang ho phekola mofetše?
Mohato oa pele oa PDT bakeng sa kalafo ea mofets'e, sesebelisoa sa photosensitizing se kenella maling. Moemeli o huloa ke lisele 'meleng oohle empa o lula liseleng tsa mofetše nako e telele ho feta kamoo o lulang liseleng tse tloaelehileng. Hoo e ka bang lihora tse 24 ho isa ho tse 72 kamora ho entoa (1), ha boholo ba moemeli a tlohetse lisele tse tloaelehileng empa a lula liseleng tsa mofetše, hlahala e pepesehetse leseli. Photosensitizer ka hlahala e monya leseli mme e hlahise mofuta o sebetsang oa oksijene o senyang lisele tsa mofets'e tse haufi (1 ?? 3).
Ntle le ho bolaea lisele tsa mofets'e ka kotloloho, PDT e bonahala e fokotsa kapa e senya lihlahala ka litsela tse ling tse peli (1 ?? 4). Photosensitizer e ka senya methapo ea mali ka hlahala, ka ho etsa joalo ea thibela mofetše ho fumana limatlafatsi tse hlokahalang. PDT le eona e ka etsa hore sesole sa 'mele se hlasele lisele tsa hlahala.
Leseli le sebelisetsoang PDT le ka tsoa ho laser kapa mehloli e meng (2, 5). Leseli la Laser le ka tsamaisoa ka likhoele tsa fiber optic (likhoele tse tšesaane tse fetisang leseli) ho fana ka leseli libakeng tse kahare ho 'mele (2). Mohlala, thapo ea fiber optic e ka kenngoa ka endoscope (tube e tšesaane, e boneselitsoeng e sebelisetsoang ho sheba lisele tse kahare ho 'mele) ka matšoafong kapa' metso ho alafa mofetše lithong tsena. Mehloli e meng ea khanya e kenyelletsa li-diode tse hlahisang khanya (li-LED), tse ka sebelisoang bakeng sa lihlahala tse kaholimo, joalo ka mofets'e oa letlalo (5).
PDT hangata e etsoa e le mokhoa oa kantle ho bakuli (6). PDT e kanna ea phetoa hape e ka sebelisoa ka mekhoa e meng ea kalafo, joalo ka ho buuoa, kalafo ea radiation, kapa chemotherapy (2).
Extracorporeal photopheresis (ECP) ke mofuta oa PDT oo mochini o sebelisetsoang ho bokella lisele tsa mali tsa mokuli, o li phekola kantle ho 'mele ka moemeli oa photosensitizing, o li pepesetsa leseli ebe o li khutlisetsa ho mokuli. Tsamaiso ea Tsamaiso ea Lijo le Lithethefatsi ea Amerika (FDA) e amohetse ECP ho thusa ho fokotsa matla a matšoao a letlalo a T-cell lymphoma e sa arabeleng liphekolo tse ling. Liphuputso li ntse li tsoela pele ho fumana hore na ECP e kanna ea ba le ts'ebeliso ea mofets'e o mong oa mali, hape e thusa ho fokotsa ho lahloa kamora ho kenella.
Ke mefuta efe ea mofetše e tšoaroang hona joale ka PDT?
Ho fihlela joale, FDA e amohetse moemeli oa photosensitizing o bitsoang porfimer sodium, kapa Photofrin®, hore e sebelisoe PDT ho phekola kapa ho imolla matšoao a mofets'e oa 'metso le mofets'e o seng o monyane oa kankere ea matšoafo. Porfimer sodium e lumelloa ho fokotsa matšoao a mofetše oa mofets'e ha mofetše o thibela 'metso kapa ha mofets'e o sa khone ho phekoloa ka mokhoa o khotsofatsang ka kalafo ea laser feela. Porfimer sodium e sebelisetsoa ho alafa mofetše o seng o monyane oa lisele tsa matšoafo ho bakuli bao kalafo e tloaelehileng e sa ba loketseng, le ho imolla matšoao ho bakuli ba nang le mofetše o seng o monyane oa lisele tsa matšoafo o sitisang moea. Ka 2003, FDA e ile ea amohela porfimer sodium bakeng sa kalafo ea liso tse ka pele ho bakuli ba nang le Barrett esophagus, boemo bo ka lebisang mofetseng oa 'metso.
Ke meeli efe ea PDT?
Leseli le hlokahalang ho kenya tšebetsong boholo ba li-photosensitizers ha le khone ho feta hoo e ka bang karolo ea boraro ea lisenthimithara tse 1 cm. Ka lebaka lena, PDT e tloaetse ho sebelisoa ho phekola lihlahala ka tlasa letlalo kapa ka tlasa letlalo kapa lera la litho tsa kahare kapa masoba (3). PDT le eona ha e sebetse hantle ho phekoleng lihlahala tse kholo, hobane leseli ha le khone ho fetela hole ho lihlahala tsena (2, 3, 6). PDT ke kalafo ea lehae mme ka kakaretso e ke ke ea sebelisoa ho alafa mofetše o namileng (metastasized) (6).
Na PDT e na le mathata kapa litla-morao?
Porfimer sodium e etsa hore letlalo le mahlo li utloe leseli libeke tse ka bang 6 kamora kalafo (1, 3, 6). Kahoo, bakuli ba eletsoa ho qoba mahlaseli a letsatsi le khanya e khanyang ea ka tlung bonyane libeke tse 6.
Li-photosensitizers li tloaetse ho ikaha ka lihlahala mme leseli le sebetsang le shebane le hlahala. Ka lebaka leo, tšenyo ea lisele tse phetseng hantle e nyane. Leha ho le joalo, PDT e ka baka ho chesa, ho ruruha, bohloko le ho fereha linthong tse haufi tse phetseng hantle (3). Litla-morao tse ling tsa PDT li amana le sebaka se alafshoang. Li ka kenyelletsa ho khohlela, bothata ba ho koenya, bohloko ba mpeng, ho hema habohloko, kapa ho hema hanyane; litla-morao tsena hangata ke tsa nakoana.
Bokamoso bo tšoere PDT joang?
Bafuputsi ba ntse ba tsoela pele ho ithuta mekhoa ea ho ntlafatsa katleho ea PDT le ho e atolosetsa ho mofets'e o mong. Liteko tsa bongaka (lithuto tsa lipatlisiso) li ntse li tsoela pele ho lekola ts'ebeliso ea PDT bakeng sa mofetše oa boko, letlalo, tšoelesa ea senya, molomo oa popelo le lesoba la mokokotlo (sebaka se ka mpeng se nang le mala, mpa le sebete). Liphuputso tse ling li shebane le nts'etsopele ea li-photosensitizers tse matla ho feta (1), tse shebileng lisele tsa mofets'e ka ho khetheha (1, 3, 5), 'me li sebelisoa ke khanya e ka kenang liseleng le ho phekola lihlahala tse tebileng kapa tse kholo (2). Bafuputsi ba ntse ba batlisisa mekhoa ea ho ntlafatsa lisebelisoa (1) le phepelo ea leseli le bonesang (5).
Litlhaloso tse khethiloeng
- Li-Dolmans DE, Fukumura D, Jain RK. Phekolo ea Photodynamic bakeng sa mofetše. Kankere ea Tlhatlhobo ea Tlhaho 2003; 3 (5): 380-387. [E ngotsoe ka Abstract]
- Mokhatlo oa Wilson oa BC. Phekolo ea Photodynamic bakeng sa mofetše: melao-motheo. Koranta ea Canada ea Gastroenterology 2002; 16 (6): 393--396. [E ngotsoe ka Abstract]
- Vrouenraets MB, Visser GW, Snow GB, van Dongen GA. Melao-motheo ea mantlha, ts'ebeliso ea oncology le ntlafatso ea khetho ea kalafo ea photodynamic. Patlisiso ea Anticancer 2003; 23 (1B): 505-522. [E ngotsoe ka Abstract]
- Dougherty TJ, Gomer CJ, Henderson BW, le al. Phekolo ea Photodynamic. Tlaleho ea Setsi sa Kankere ea Naha 1998; 90 (12): 889–905. [E ngotsoe ka Abstract]
- Gudgin Dickson EF, Goyan RL, Pottier RH. Litsela tse ncha kalafong ea photodynamic. Lisele le Biology ea Limolek'hule 2002; 48 (8): 939-954. [E ngotsoe ka Abstract]
- Capella MA, Capella LS. Leseli ho hanyeng ha meriana e mengata: kalafo ea Photodynamic ea lihlahala tse thibelang meriana. Tlaleho ea Saense ea Biomedical 2003; 10 (4): 361-366. [E ngotsoe ka Abstract]
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