光動力刀 延長肺癌病患存活
http://n.yam.com/tlt/healthy/201008/20100826570763.html
自由時報╱自由時報 2010-08-26 06:01 調整字級： 記者魏怡嘉／台北報導
49歲的蔡玉玲罹患肺癌近10年，3年前，病情惡化，癌細胞往兩側肋膜復發轉移，接受傳統治療卻一直沒有起色，一度讓她覺得「生不如死」。
幸運的是，新光醫院當時剛開始發展光動力刀（PDT）手術治療，並請來美國賓州大學肋膜癌症中心的手術團隊進行手術示範，她成了首例示範病例，成功地控制腫瘤侵犯。
新光醫院外科部胸腔外科主任謝義山表示，肺癌細胞生長快速，很早就發生轉移，這時只能仰賴傳統化學治療或放射治療，但療效相當差，5年存活率僅約20%到30%，平均存活年限不到1年，即使加上標靶治療，也僅能延長平均壽命3個月。
謝義山指出，晚期肺癌可怕之處在於，約有30%患者會發生癌細胞轉移到肋膜，病人因反覆肋膜積水造成喘、呼吸困難，生活品質差，且平均存活率僅剩6到9個月。
光動力刀手術治療突破過去晚期肺癌癌細胞轉移到肋膜腔後，無法用手術清除的治療瓶頸，可利用光動力刀的雷射殺死轉移到表層肋膜的癌細胞，達到癌症局部控制。
新光醫院引進此項手術治療3年多來，已有近30例肺癌末期病患接受此項治療，其中存活最久的病患已將近4年，但目前健保不給付，病患須自費50萬元。
這個PDT
不知道和眼科用來治療脈絡膜新生血管的PDT一樣嗎
(咦) (咦)
光動力刀 延長肺癌病患存活
版主: 版主021
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blind faith
- CR
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Re: 光動力刀 延長肺癌病患存活
初期肺癌術後, 3年前復發? 罹癌近10年?49歲的蔡玉玲罹患肺癌近10年，3年前，病情惡化........
malignant pleural effusion 在AJCC,7th 已算stage IV.
光靠xx刀, 真有神效? ( XRT is just local therapy !)
要說, 手上也有光靠吃標靶藥物就超過3 年的病人 (現在還是 stable)....
廣告文, selective patient 的狀況無法代表全貌.....
'We are all just prisoners here of our own device'
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OYAYA168
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Re: 光動力刀 延長肺癌病患存活
請問 STAGE IV ADENOCARCINOMA 現吃標靶藥物 可用嗎blind faith 寫:初期肺癌術後, 3年前復發? 罹癌近10年?49歲的蔡玉玲罹患肺癌近10年，3年前，病情惡化........
malignant pleural effusion 在AJCC,7th 已算stage IV.
光靠xx刀, 真有神效? ( XRT is just local therapy !)
要說, 手上也有光靠吃標靶藥物就超過3 年的病人 (現在還是 stable)....
廣告文, selective patient 的狀況無法代表全貌.....
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JustInCase
- CR
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- 註冊時間: 週三 10月 24, 2007 3:11 am
- 來自: 火星
Re: 光動力刀 延長肺癌病患存活
這不是單純的Radiotherapy，其實治療原理以前上課時就聽過，
不能適用於所有癌症，但是對於malignant pleural effusion似乎應該是可以試試看...
What is photodynamic therapy? (From National Cancer Institute)
Photodynamic therapy (PDT) is a treatment that uses a drug, called a photosensitizer or photosensitizing agent, and a particular type of light. When photosensitizers are exposed to a specific wavelength of light, they produce a form of oxygen that kills nearby cells (1, 2, 3).
Each photosensitizer is activated by light of a specific wavelength (3, 4). This wavelength determines how far the light can travel into the body (3, 5). Thus, doctors use specific photosensitizers and wavelengths of light to treat different areas of the body with PDT.
How is PDT used to treat cancer?
In the first step of PDT for cancer treatment, a photosensitizing agent is injected into the bloodstream. The agent is absorbed by cells all over the body but stays in cancer cells longer than it does in normal cells. Approximately 24 to 72 hours after injection (1), when most of the agent has left normal cells but remains in cancer cells, the tumor is exposed to light. The photosensitizer in the tumor absorbs the light and produces an active form of oxygen that destroys nearby cancer cells (1, 2, 3).
In addition to directly killing cancer cells, PDT appears to shrink or destroy tumors in two other ways (1, 2, 3, 4). The photosensitizer can damage blood vessels in the tumor, thereby preventing the cancer from receiving necessary nutrients. In addition, PDT may activate the immune system to attack the tumor cells.
The light used for PDT can come from a laser or other sources of light (2, 5). Laser light can be directed through fiber optic cables (thin fibers that transmit light) to deliver light to areas inside the body (2). For example, a fiber optic cable can be inserted through an endoscope (a thin, lighted tube used to look at tissues inside the body) into the lungs or esophagus to treat cancer in these organs. Other light sources include light-emitting diodes (LEDs), which may be used for surface tumors, such as skin cancer (5).
PDT is usually performed as an outpatient procedure (6). PDT may also be repeated and may be used with other therapies, such as surgery, radiation, or chemotherapy (2).
What types of cancer are currently treated with PDT?
To date, the U.S. Food and Drug Administration (FDA) has approved the photosensitizing agent called porfimer sodium, or Photofrin®, for use in PDT to treat or relieve the symptoms of esophageal cancer and non-small cell lung cancer. Porfimer sodium is approved to relieve symptoms of esophageal cancer when the cancer obstructs the esophagus or when the cancer cannot be satisfactorily treated with laser therapy alone. Porfimer sodium is used to treat non-small cell lung cancer in patients for whom the usual treatments are not appropriate, and to relieve symptoms in patients with non-small cell lung cancer that obstructs the airways. In 2003, the FDA approved porfimer sodium for the treatment of precancerous lesions in patients with Barrett esophagus (a condition that can lead to esophageal cancer).
What are the limitations of PDT?
The light needed to activate most photosensitizers cannot pass through more than about one-third of an inch of tissue (1 centimeter). For this reason, PDT is usually used to treat tumors on or just under the skin or on the lining of internal organs or cavities (3). PDT is also less effective in treating large tumors, because the light cannot pass far into these tumors (2, 3, 6). PDT is a local treatment and generally cannot be used to treat cancer that has spread (metastasized) (6).
Does PDT have any complications or side effects?
Porfimer sodium makes the skin and eyes sensitive to light for approximately 6 weeks after treatment (1, 3, 6). Thus, patients are advised to avoid direct sunlight and bright indoor light for at least 6 weeks.
Photosensitizers tend to build up in tumors and the activating light is focused on the tumor. As a result, damage to healthy tissue is minimal. However, PDT can cause burns, swelling, pain, and scarring in nearby healthy tissue (3). Other side effects of PDT are related to the area that is treated. They can include coughing, trouble swallowing, stomach pain, painful breathing, or shortness of breath; these side effects are usually temporary.
What does the future hold for PDT?
Researchers continue to study ways to improve the effectiveness of PDT and expand it to other cancers. Clinical trials (research studies) are under way to evaluate the use of PDT for cancers of the brain, skin, prostate, cervix, and peritoneal cavity (the space in the abdomen that contains the intestines, stomach, and liver). Other research is focused on the development of photosensitizers that are more powerful (1), more specifically target cancer cells (1, 3, 5), and are activated by light that can penetrate tissue and treat deep or large tumors (2). Researchers are also investigating ways to improve equipment (1) and the delivery of the activating light (5).
Selected References
Dolmans DEJGJ, Fukumura D, Jain RK. Photodynamic therapy for cancer. Nature Reviews Cancer 2003; 3(5):380–387.
Wilson BC. Photodynamic therapy for cancer: Principles. Canadian Journal of Gastroenterology 2002; 16(6):393–396.
Vrouenraets MB, Visser GWM, Snow GB, van Dongen GAMS. Basic principles, applications in oncology and improved selectivity of photodynamic therapy. Anticancer Research 2003; 23:505–522.
Dougherty TJ, Gomer CJ, Henderson BW, et al. Photodynamic therapy. Journal of the National Cancer Institute 1998; 90(12):889–905.
Dickson EFG, Goyan RL, Pottier RH. New directions in photodynamic therapy. Cellular and Molecular Biology 2003; 48(8):939–954.
Capella MAM, Capella LS. A light in multidrug resistance: Photodynamic treatment of multidrug-resistant tumors. Journal of Biomedical Science 2003; 10:361–366.
不能適用於所有癌症，但是對於malignant pleural effusion似乎應該是可以試試看...
What is photodynamic therapy? (From National Cancer Institute)
Photodynamic therapy (PDT) is a treatment that uses a drug, called a photosensitizer or photosensitizing agent, and a particular type of light. When photosensitizers are exposed to a specific wavelength of light, they produce a form of oxygen that kills nearby cells (1, 2, 3).
Each photosensitizer is activated by light of a specific wavelength (3, 4). This wavelength determines how far the light can travel into the body (3, 5). Thus, doctors use specific photosensitizers and wavelengths of light to treat different areas of the body with PDT.
How is PDT used to treat cancer?
In the first step of PDT for cancer treatment, a photosensitizing agent is injected into the bloodstream. The agent is absorbed by cells all over the body but stays in cancer cells longer than it does in normal cells. Approximately 24 to 72 hours after injection (1), when most of the agent has left normal cells but remains in cancer cells, the tumor is exposed to light. The photosensitizer in the tumor absorbs the light and produces an active form of oxygen that destroys nearby cancer cells (1, 2, 3).
In addition to directly killing cancer cells, PDT appears to shrink or destroy tumors in two other ways (1, 2, 3, 4). The photosensitizer can damage blood vessels in the tumor, thereby preventing the cancer from receiving necessary nutrients. In addition, PDT may activate the immune system to attack the tumor cells.
The light used for PDT can come from a laser or other sources of light (2, 5). Laser light can be directed through fiber optic cables (thin fibers that transmit light) to deliver light to areas inside the body (2). For example, a fiber optic cable can be inserted through an endoscope (a thin, lighted tube used to look at tissues inside the body) into the lungs or esophagus to treat cancer in these organs. Other light sources include light-emitting diodes (LEDs), which may be used for surface tumors, such as skin cancer (5).
PDT is usually performed as an outpatient procedure (6). PDT may also be repeated and may be used with other therapies, such as surgery, radiation, or chemotherapy (2).
What types of cancer are currently treated with PDT?
To date, the U.S. Food and Drug Administration (FDA) has approved the photosensitizing agent called porfimer sodium, or Photofrin®, for use in PDT to treat or relieve the symptoms of esophageal cancer and non-small cell lung cancer. Porfimer sodium is approved to relieve symptoms of esophageal cancer when the cancer obstructs the esophagus or when the cancer cannot be satisfactorily treated with laser therapy alone. Porfimer sodium is used to treat non-small cell lung cancer in patients for whom the usual treatments are not appropriate, and to relieve symptoms in patients with non-small cell lung cancer that obstructs the airways. In 2003, the FDA approved porfimer sodium for the treatment of precancerous lesions in patients with Barrett esophagus (a condition that can lead to esophageal cancer).
What are the limitations of PDT?
The light needed to activate most photosensitizers cannot pass through more than about one-third of an inch of tissue (1 centimeter). For this reason, PDT is usually used to treat tumors on or just under the skin or on the lining of internal organs or cavities (3). PDT is also less effective in treating large tumors, because the light cannot pass far into these tumors (2, 3, 6). PDT is a local treatment and generally cannot be used to treat cancer that has spread (metastasized) (6).
Does PDT have any complications or side effects?
Porfimer sodium makes the skin and eyes sensitive to light for approximately 6 weeks after treatment (1, 3, 6). Thus, patients are advised to avoid direct sunlight and bright indoor light for at least 6 weeks.
Photosensitizers tend to build up in tumors and the activating light is focused on the tumor. As a result, damage to healthy tissue is minimal. However, PDT can cause burns, swelling, pain, and scarring in nearby healthy tissue (3). Other side effects of PDT are related to the area that is treated. They can include coughing, trouble swallowing, stomach pain, painful breathing, or shortness of breath; these side effects are usually temporary.
What does the future hold for PDT?
Researchers continue to study ways to improve the effectiveness of PDT and expand it to other cancers. Clinical trials (research studies) are under way to evaluate the use of PDT for cancers of the brain, skin, prostate, cervix, and peritoneal cavity (the space in the abdomen that contains the intestines, stomach, and liver). Other research is focused on the development of photosensitizers that are more powerful (1), more specifically target cancer cells (1, 3, 5), and are activated by light that can penetrate tissue and treat deep or large tumors (2). Researchers are also investigating ways to improve equipment (1) and the delivery of the activating light (5).
Selected References
Dolmans DEJGJ, Fukumura D, Jain RK. Photodynamic therapy for cancer. Nature Reviews Cancer 2003; 3(5):380–387.
Wilson BC. Photodynamic therapy for cancer: Principles. Canadian Journal of Gastroenterology 2002; 16(6):393–396.
Vrouenraets MB, Visser GWM, Snow GB, van Dongen GAMS. Basic principles, applications in oncology and improved selectivity of photodynamic therapy. Anticancer Research 2003; 23:505–522.
Dougherty TJ, Gomer CJ, Henderson BW, et al. Photodynamic therapy. Journal of the National Cancer Institute 1998; 90(12):889–905.
Dickson EFG, Goyan RL, Pottier RH. New directions in photodynamic therapy. Cellular and Molecular Biology 2003; 48(8):939–954.
Capella MAM, Capella LS. A light in multidrug resistance: Photodynamic treatment of multidrug-resistant tumors. Journal of Biomedical Science 2003; 10:361–366.