光敏剂放射动力治疗:实验和临床研究综述

D. Tzerkovsky, A. Mazurenko, F.F. Borychevsky, D.V. Shashkouski
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摘要

光动力疗法(PDT)是一种基于光的方法,它使用光反应分子,如不同类型的光敏剂(PS),来破坏恶性肿瘤。正如一些作者所证明的那样,PS在x射线照射下通过增强活性氧的产生而被证明是一种放射性反应分子。这种基于PS和电离辐射联合使用的治疗方法被称为“放射动力学治疗”(RDT)。RDT相对于PDT的优势在于x射线穿透组织的能力,这将在深部恶性肿瘤的治疗中找到许多应用。来自日本、德国、以色列、立陶宛等多个研究中心的作者介绍了在肿瘤细胞系和移植肿瘤动物实验中使用RDT的经验。该方法已开始在无法切除的膀胱癌、宫颈癌、胶质瘤和其他形式的恶性肿瘤患者中获得临床批准。肿瘤细胞和移植肿瘤动物培养实验数据表明,RDT与各种类型的PS均具有较高的抗肿瘤功效。与对照组(包括单组放射治疗组)相比,RT和PS联合使用可显著降低肿瘤活细胞,并明显抑制移植肿瘤的生长,这一事实得到了证实。初步数据显示,该方法在临床肿瘤学中具有良好的耐受性(无严重不良反应),抗肿瘤效果令人满意(客观反应频率增加,肿瘤体积缩小百分比增加,使其有可能转移到可切除状态)。
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Radiodynamic Therapy with Photosensitizers: Mini-Review of Experimental and Clinical Studies
Photodynamic Therapy (PDT) is a light-based method that uses photo-reactive molecules, such as different types of photosensitizers (PS), to destroy malignant tumors. As some authors testify, PS was shown to act as a radio-reactive molecule by enhancing generation of reactive oxygen species upon X-ray irradiation. The method of treatment, which is based on the combined use of PS and ionizing radiation, is called «Radiodynamic therapy» (RDT). The advantage of RDT over PDT is the X-ray’s penetrability through tissues, which will find many applications for treatment of deep malignant tumors. The authors of a number of research centers in Japan, Germany, Israel and Lithuania presented the experience of using RDT in experiments on tumor cell lines and animals with transplanted tumors. A clinical approbation of the method has been started in patients with unresectable forms of bladder and cervical cancer, with gliomas and other forms of malignant tumors. The data obtained in experiments on cultures of tumor cells and animals with transplanted tumors indicate a high antitumor efficacy of the RDT with various types of PS. This fact is confirmed by a statistically significant decrease in viable tumor cells with the combined use of RT and PS, as well as a pronounced inhibition of the growth of transplanted tumors compared with the control groups, including the group of radiation therapy in mono mode. The preliminary data obtained show good tolerability of the method in clinical oncology (no serious adverse reactions) and satisfactory antitumor efficacy (an increase in the frequency of objective responses and an increase in the % reduction in tumor volume, which made it possible to transfer them to a resectable state).
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