申请分类新药-第三军医大学学报.doc

手术联合局部光动力疗法在皮肤中的观察 王元元 杨亚东 高 杨 杨洋 寇慧玲 杨云川 李国灵 鲁元刚第三军医大学医院野战外科研究所美容科 (重庆，400042) [摘要] 目的 评价在皮肤肿瘤治疗中的。方法 入选病例包括基底细胞癌例、鲍温病例、湿疹样癌例、鳞癌例手术切除病灶后辅助局部光动力学治疗。局部光动力疗法采用5-ALA作为光敏剂，在避光条件下将10%的5-ALA乳液均匀涂抹于肿瘤病灶表面，持续敷药4小时。用波长为635nm的激光照射病灶部位，光照剂量为120J/cm2，每一部位照射时间为15分钟。手术后辅助光动力学治疗为3次，每次治疗间隔2周，治疗后2周复诊，照相，比较治疗前后的皮损，评价治疗效果。术后长期随访，观察肿瘤复发情况。结果 术联合，半年时未见复发1年时8例湿疹样癌中有5例复发，5例鳞癌中有2例复发，其它病例未见复发。 结论 　局部光动力疗法作为皮肤肿瘤切除术后的辅助治疗，可减少肿瘤病灶的切除范围在手术难度极大的肿瘤病例治疗中有积极意义，但在降低复发率方面仍有待于进一步探索。[关键词]局部光动力，皮肤恶性肿瘤，5-ALA，疗效 Efficacy of topical ALA-PDT in the treatment of skin malignant tumor Wang Yuanyuan, Yang Yadong, Gao Yang, Yang Yang , Kou Huiling, Yang Yunchuan, Li Guoling, Lu Yuangang, Department of CosmeticPlastic Surgery, Research Institute of Surgery, Third Affiliated Hospital of Third Military Medical University, Chongqing 400042, P. R.China [Abstract] Objective To evaluate the efficacy of surgery combining topical photodynamic therapy (PDT) using aminolevulinic acid (5-ALA) in the treatment of skin malignant tumor and the role of surgical improvements. Methods Selected cases including 32 cases of basal cell caicinoma, Bowen’s disease in 13 cases, 8 cases of Paget’s disease, squamous cell caicinoma in 5 cases. All cases were treated with topical aminolevulinic acid photodynamic therapy (ALA-PDT) after surgery. We used 5-ALA as a photosensitizer, 10% 5-ALA cream was applied to the surface of the skin tumor with occlusive dressing for a 4h incubation period in the dark conditions, and each tumor lesion was exposed to a fluence rate of 200mW/cm2 of 635nm light from a diode laser for 15min, corresponding to a total dose of 120 J/cm2 . Assisted ALA-PDT was applied 3 times after surgery, each time interval was 2 weeks, follow-up was performed at our outpatient clinic 2 weeks after the last therapy. Before treatment and each return visit, lesions were photographed. Meanwhile, the efficacy was evaluated after PDT. We observed the tumor recurrence rate of the postoperative long-term follow-up.