Purpose To evaluate shortterm visual acuity effects of a single photodynamic therapy(PDT) treatment with Visudyne (CIBA Vision Corp, Duluth, Ga) for choroidal neovascularization (CNV) in age-related macular degeneration (AMD). Methods Definitely diagnostic AMD patients with classic CNV were treated with PDT (5 cases, 7 eyes). The data of visual acuity testing, ophthalmic examination, color photographs, optic coherence tomography, fluorescein angiograms and indocyanine green angiogram before photodynamic therapy and 1 week ,1 month after it were used to evaluate the effects of a single treatment of PDT with Visudyne. Results The visual acuity of all the treated eyes at the follow-up examination at 1 month after PDT were not reduced. Distinct reduction of fluorescein leakage from CNV was noted in all patients by 1 week after PDT. Fluorescein leakage from a portion of the CNV reappeared by 1 month after treatment in 2 eyes. Conclusion PDT with Visudyne achieved short-term cessation of fluorescein leakage from CNV without loss of vision or growth of classic CNV in some patwo ients with AMD. (Chin J Ocul Fundus Dis,2000,16:213-216)
Objective To assess the efficacy and safety of photodynamic therapy (PDT) for cutaneous bowen disease. Methods We electronically searched PubMed, OVID, Cochrane Central Register of Controlled Trials, CBM, and CNKI databases from January, 1966 to March, 2010. The language was confined to English and Chinese. We screened the retrieved randomized controlled trials (RCTs) according to the predefined inclusion criteria, evaluated the quality of the included studies, and performed meta-analysis with RevMan 5.0.23 software. Results Five RCTs were included; among all 496 skin leisions on 354 patients, 237 were in trial group while the other 259 were in control group. The healing rate of PDT was higher than that of both placebo (RR=4.16, 95%CI 1.69 to 10.25) and topical fluorouracil (RR=1.38, 95%CI 1.12 to 1.71), and was similar to that of cryotherapy. The cosmetic outcome evaluation of PDT was better than that of both cryotherapy (RR=1.48, 95%CI 1.18 to 1.87) and topical fluorouracil treatment (RR=1.51, 95%CI 1.05 to 2.15). The recurrence rate of PDT was lower than that of placebo (RR=0.29, 95%CI 0.10 to 0.86), and was similar with cryotherapy or topical fluorouracil treatment respectively. The healing rate of PDT with red light source was higher than that of PDT with green light (RR=1.29, 95%CI 1.02 to 1.65), and the recurrence rate of the former was lower than that of the latter (RR=0.20, 95%CI 0.05 to 0.87). There was no difference between 2-fold illumination scheme and single illumination scheme in the healing rate or the cosmetic outcome evaluation. The adverse effects include pain, cacesthesia, inflammatory reaction, hyperpigmentation, and crusting. Conclusion The limited evidence indicates that the efficacy of PDT is better than those of placebo, cryotherapy or topical fluorouracil treatment, the recurrence rate of PDT is lower than that of placebo, and the adverse effects are similar comparing to control groups. The PDT with red light source is superior to PDT with green light source for having better effectiveness, less recurrence and similar adverse effects. The 2-fold illumination scheme and single illumination scheme have similar efficacy, but the former is more painful.
Objective To assess the effectiveness and safety of photodynamic therapy (PDT) for patients with nonresectable bile duct cancer. Methods Two reviewers independently searched The Cochrane Library (issue 4, 2006), MEDLINE (1966 to February 2007), CNKI (1994 to February 2007) and VIP (1989 to February 2007), respectively. The quality of included studies was assessed according to the guidance in the Cochrane Handbook of Systematic Reviews of Interventions. Results Two randomized controlled trials involving 71 patients with nonresectable bile duct cancer met the inclusion criteria and were included. Both of these trials reported that the median survival time in patients who were treated with endoprostheses and PDT was longer than for those treated with endoprostheses alone (493 days versus 98 days, and 21 months versus 7 months, in the two trials respectively) One trial reported that the global quality of life in patients in the PDT with endoprostheses group was significantly better than that for the endoprostheses alone group: the difference of Karnofshy index between the two groups was 25.4 (14.4-36.3). The other trial reported no difference between the two groups. No severe adverse effects were observed during either trial. Conclusion Current evidence demonstrates that PDT can improve the survival time of patients with nonresectable bile duct cancer, and reduce the burden of treatment. The treatment might increase biliary infectious rate, but this can be managed by antibiotics therapy. No severe adverse effects are observed. More randomized controlled trials, with large sample sizes, may lead to more accurate results.
目的 评估光动力疗法联合曲安奈德治疗渗出型老年性黄斑变性（AMD）的临床疗效及对患者生活质量的影响。 方法 将2007年12月－2010年12月就诊的35例（38只眼）渗出型AMD患者采用随机数字表法随机分为两组，治疗组18例（20只眼）采用光动力疗法联合玻璃体腔内注射曲安奈德治疗，对照组17例（18只眼）单用光动力疗法。评估患者视力和眼底影像学改变，同时也评估对患者生活质量的影响。两组均随访12个月。 结果 随访12个月后，光动力疗法联合曲安奈德治疗组视力不变者8例9只眼，占45.0%；视力提高者9例10只眼，占50.0%；视力下降者1例1只眼，占5.0%。吲哚青绿血管造影结果显示，脉络膜新生血管（CNV）渗漏停止7例7只眼，占35.0%；持续渗漏或渗漏增加者1例1只眼，占5.0%；渗漏减少者11例12只眼，占60.0%。光动力疗法治疗组视力不变者6例6只眼，占33.3%；视力提高者4例5只眼，占27.8%；视力下降者7例7只眼，占38.9%。吲哚青绿血管造影结果显示，CNV渗漏停止3例3只眼，占16.7%；持续渗漏或渗漏增加者5例6只眼，占33.3%；渗漏减少者9例9只眼，占50.0%。联合治疗组与单用光动力疗法组在视力改变方面差异有统计学意义（χ2=4.67，P=0.03），在吲哚青绿血管造影结果方面差异有统计学意义（χ2=3.35，P=0.01）。中文译本低视力者生存质量量表评估生活质量治疗组平均得分（102.02 ± 16.20）分，对照组平均得分为（91.27 ± 11.81）分，两组比较差异有统计学意义（P＜0.05）。 结论 光动力疗法联合曲安奈德治疗渗出型AMD疗效优于单用光动力疗法。
目的:评价外用盐酸氨酮戊酸散光动力疗法治疗尖锐湿疣的临床疗效。方法:采用开放、高频电离子平行对照的临床研究方法。治疗组28例患者,采用外用盐酸氨酮戊酸散光动力疗法,一周治疗一次,连续治疗三周;对照组37例患者,采用高频电离子切割治疗。两组患者均在末次治疗后第一周进行疗效评价及不良反应观察,第4、8、12周观察复发率。结果:1例患者因三次外用盐酸氨酮戊酸散光动力疗法后疣体脱落而提前终止试验,64例患者完成了全部的随访。在末次治疗后1周时疣体清除率:治疗组为96.4%,对照组为100%,其中尿道口的疣体清除率:两组均为100%;非尿道口的疣体清除率:治疗组为91.67%,对照组100%,无论是尿道口还是非尿道口尖锐湿疣,两组的疗效无统计学差异(Pgt;0.05)。治疗后随访12周的复发率:治疗组为 6.86%,对照组24.32%, Plt;0.05;其中尿道口的复发率:治疗组为 5.88%,对照组42.86%,Plt;0.05;非尿道口的疣体清除率:治疗组为8.33%,对照组为20%,Plt;0.05。两组均具有统计学差异。两组均没有出现系统不良反应,局部不良反应率:治疗组为7.14%,主要为轻度糜烂、疼痛、渗液;对照组为4865%,主要为溃疡、疼痛、疤痕等,治疗组不良反应发生率均明显低于对照组,差异有统计学意义。结论：ALA-PDT清除率高，复发率低，安全，耐受性好，无明显副作用，可作为尿道口CA治疗首选。
【Abstract】ObjectiveTo investigate the effects of endogenous photodynamic therapy (PDT) on intracellular cAMP and cGMP concentrations of human colon carcinoma cell lines SW480. MethodsSW480 cells were divided into control group, light group, δaminolevulinic acid （ALA） group (ALA group) and endogenous PDT group (ALAPDT group). Intracellular cAMP and cGMP concentrations of each group were detected by radioimmunoassay at 30, 60, 90 and 120 min after irradiation. ResultsThere was a significant increase in intracellular cAMP concentration of ALAPDT group at 30 min after irradiation (P＜0.001) and sequent decrease, but intracellular cAMP concentrations of ALAPDT group at 60, 90 and 120 min after irradiation had no statistical difference than the other groups (Pgt;0.05). Intracellular cGMP concentration of different time point of each group was not significantly different. ConclusionThese results indicate that the cytoprotection of SW480 cell are produced by an instantaneous increase in the intracellular cAMP concentration while endogenous PDT is killing SW480 cell.
ObjectiveTo understand the research advance of photodynamic therapy (PDT) on cholangiocarcinoma. MethodDomestic and international publications online which involving the research of PDT on cholangiocarcinoma in recent years were reviewed. Results①PDT was a new therapy on tumor from the tissue and cell level, which could destroy the target tissue and cell under the photochemical reaction and kill the tumor cell according to the characteristics of the selective intake of tumor tissue on particular photosensitizer. It could mainly induce tumor cell apoptosis and necrosis, destroy the tumor microvascular, stimulate the immune and inflammatory response.②PDT on the research level of the treatment of cholangiocarcinoma had achieved fairly good curative effects, which could make the tumor shrinkage, reduce the harm to normal bile duct cell, and prolong the survival, improve the survival rate and the quality of life.③Proliferating cell nuclear antigen (PCNA), vascular endothelial growth factor-C (VEGF-C), and cyclooxygenase-2 (COX-2) played important roles in the development of cholangiocarcinoma. PDT could inhibit the expressions of PCNA, VEGF-C, and COX-2, and then could promote cell apoptosis, and then inhibit cell proliferation. ConclusionsPDT is a new technology in treatment of malignant tumor, which whether used alone or combined with other methods has less adverse reaction and could obviously improve the local symptoms in treatment of cholangiocarcinoma. But many problems about PDT need to be solved at present, in the base areas, such as research and development of new photosensitizer and precise mechanism of killing tumor, in the clinical applications, such as selection and application of photosensitizer, ways and parameters of the laser, formulation of treatment plans and the reduction of the complications.
Objective To explore the effect of pyropheophorbide-a methyl ester-mediated photodynamic therapy (MPPa-PDT) on the apoptosis in human osteosarcoma cell line MG63 and the underlying mechanism. Methods Human osteosarcoma MG63 cells in logarithmic growth phase were divided into 4 groups: blank control group (control group), the MPPa treatment group (MPPa group), the light irradiation group (LED group), and MPPa-PDT treatment group (MPPa-PDT group). MPPa-PDT group and MPPa group were incubated with MPPa (0.75 μmol/ L) for 20 hours in dark condition; control group and LED group were incubated with equal volume of fresh medium for 20 hours in the same condition. After washing with PBS and replacement with fresh culture medium, LED group and MPPa-PDT group cells were exposed to light (4.8 J/cm2) for 120 seconds. After light exposure, all groups were cultured in dark condition again. Then cellular morphology changes were observed by an inverted phase contrast microscopy, endoplasmic reticulum morphology changes were observed by transmission electron microscopy, cellular apoptosis was detected by Hoechst33258 nuclear staining, cell apoptotic rate and the levels of Ca in cells were analyzed by flow cytometry, the expression of p-PERK, C/EBP homologous protein (CHOP), cleaved-Caspase-12 were assayed by Western blot. Results In MPPa-PDT group, the retracted and round cells were observed; Hoechst33258 nuclear staining showed nuclear condensation, fragmentation, and other typical apoptotic morphological changes; the cell apoptotic rate (48.76%±3.54%) was significantly higher than that of control group (5.04%±0.41%), MPPa group (5.33%±0.38%), and LED group (6.48%±0.46%) (P < 0.05); the levels of Ca2+ in cells (485.29±58.77) was also significantly higher than that of control group (97.24±4.77), MPPa group (97.95±6.30), and LED group (101.17±5.26) (P < 0.05); swelling endoplasmic reticulum was observed under transmission electron microscope; the expressions of p-PERK, CHOP, and cleaved-Caspase-12 gradually increased at 1, 3, and 6 hours after treatment respectively, which were significantly higher than those of the other groups (P < 0.05). There was no typical apoptotic morphological changes and endoplasmic reticulum morphological changes in control group, MPPa group, and LED group, and there was no significant difference in the above indexes among 3 groups (P > 0.05). Conclusion MPPa-PDT can significantly induce apoptosis in MG63 cells. The endoplasmic reticulum stress pathway is involved in the MPPa-PDT induced apoptosis.