子宮頸部癌治療へのPDTの効用

抄録

The incidence of CIS and dysplasia of the uterine cervix is increasing among young women in the recent years. Most of these patients want to preserve their fertility, and some of them are inoperable or refuse surgery. To avoid surgery, high power laser with CO₂ or YAG laser are most often used, but just like the conventional conization, these therapies cause unexpected bleedings and may destroy uterine cervical glands indispensable for pregnancy and delivery. PDT with the use of EDL-a type of pulse laser, has a considerably higher degree of tissue penetration, even compared to the PDT using argon dye laser. It also has a special feature: selective destroying of malignant cells with almost no effect on normal tissue. Furthermore, PDT is performed without anesthesia, since it causes no pain or bleeding.
We studied clinically this method on 39 patients until now. PDT is performed 48 hours after the intravenous injection of photosensitizer Photofrin II (PHE). Out of 24 CIS and 15 dysplasia patients, there were 38 CR (97.4%) and only one NC case. The NC case is thought to be due to the insufficient photo radiation of lesions surrounding the portio. The first CR case was four years ago and no recurrence has been observed yet.
PDT seems to be the most appropriate known method in treating early stages of uterine cervical cancer, as it satisfies our main condition of fertility preservation. With little side effects, no bleeding or pain,and with certain improvements in administration methods, better choice of photosensitizer which would shorten the shading time, PDT promises a brighter future for physicians and their patients in fighting cervical cancer.