구강악안면외과 영역의 전암병소 및 악성종양 치료를 위한 광역학 요법의 이용

PHOTODYNAMIC THERAPY OF PREMALIGNANT AND MALIGNANT LESIONS IN ORAL AND MAXILLOFACIAL SURGERY

  • 오정환 (독일 쾰른대학교 의학부 구강악안면외과학교실) ;
  • ;
  • Oh, Jung-Hwan (Department of Oral and Maxillofacial Surgery, University of Cologne) ;
  • Kubler, Alexander (Department of Oral and Maxillofacial Surgery, University of Cologne) ;
  • Zoller, Joachim E. (Department of Oral and Maxillofacial Surgery, University of Cologne)
  • 발행 : 2002.06.30

초록

구강악안면외과 영역의 전암병소와 종양의 치료를 위하여 국소적으로 ALA, 전신적으로 Forscan의 광감각제를 도포하거나 주입하여 기능적, 심미적으로 좋은 결과를 얻을 수 있었다. 아직 장기적인 추적조사가 요구되지만 광역학 요법은 기존의 수술법, 항암요법, 방사선치료와 함께 종양의 새로운 치료방법으로 이용될 수 있을 것으로 사료된다.

Photodynamic therapy (PDT) is based on a photochemical reaction which is initiated by light activation of a photosensitizer. The photosensitizer accumulates more in tumor tissues than in normal tissues and is activated with specific wavelength of light, usually laser. The photochemical reaction produces highly reactive oxygen products causing cytotoxiciy and vascular shutdown to the tumor. The advantages of PDT are its relative selective tumor destruction and tissue healing by regeneration, which can maintain important structures with very good functional and esthetic results. Therefore, PDT is considered as an alternative modality for cancers of the head and neck. In this article, we will report three cases of photodynamic therapy for treatment of oral leukoplakia, squamous cell carcinoma, and basal cell carcinoma of head and neck. It was observed that premalignant and malignant lesions responded well to the photodynamic therapy with Aminolevulinic acid (ALA) and $Foscan^{(R)}$. Photodynamic therapy can be considered as a new treatment method for the premalignant and malignant tumors in Oral and Maxillofacial Surgery.

키워드

참고문헌

  1. Von Tappeiner H, Jodblauer A: Ueber die Wirkung der photodynamischen (fluorescierenden) Stoffe auf Prozoen und Enzyme. Dtsch Arch Klin Med 80: 427-87 (1904)
  2. Kelly JF, Snell ME, Berenbaum MC: Photodynamic destruction of human bladder carcinoma. Br J Cancer 31: 237-244 (1975)
  3. Suhr MAA, Hopper C, MacRobert AJ, Speight PM, Kuebler AC, Kunz L: Klinische Pilotstudie zur interstitiellen photodynamischen Therapie fuer die Behandlung von fortgeschrittenen Kopf-Has- Tumoren. Mund Kiefer Gesichtschir 5: 277-282 (2001)
  4. Kessel D, Dougherty TJ: Agents used in photodynamic therapy. Contemp Pharmacother 10: 19-24 (1999)
  5. Henderson BW, Dougherty TJ: How does photodynamic therapy work? Photochem Photobiol 55:145-157 (1992)
  6. Kuebler A, Haase T, Kremer P, Rheinwald M, Kunze S, Muehling J: An argon-dye laser system for photodynamic therapy and diagnosis. Neurol Res 21: 103-107 (1999)
  7. Dilkes MG, Dejode ML, Gardiner Q, Kenyon GS, McKelvie P: Treatment of head and neck cancer with photodynamic therapy: results after one year. J Laryngol Otol 109: 1072-1076
  8. Rausch PC, Rolfs F, Winkler MR, Kottysch A, Schauer A, Steiner W: Pulsed versus continous wave excitation mechanism in photodynamic therapy of differently graded squamous cell carcinomas in tumor-implanted nude mice. Eur Arch Otorhinolaryngol 250: 82-87 (1993)