Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Effect of Photodynamic Therapy in Lung Cancer

폐암에서 광역동치료술의 효과

  • Yoon, Sung Ho (Department of Internal Medicine, Chosun University, College of Medicine) ;
  • Han, Kyung Taek (Department of Internal Medicine, Chosun University, College of Medicine) ;
  • Kim, Gyung Nam (Department of Internal Medicine, Chosun University, College of Medicine) ;
  • Lee, Seung Il (Department of Internal Medicine, Chosun University, College of Medicine)
  • 윤성호 (조선대학교 의과대학 내과학교실) ;
  • 한경택 (조선대학교 의과대학 내과학교실) ;
  • 김경남 (조선대학교 의과대학 내과학교실) ;
  • 이승일 (조선대학교 의과대학 내과학교실)
  • Received : 2004.03.26
  • Accepted : 2004.08.24
  • Published : 2004.10.30
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Abstract

Background : Photodynamic therapy (PDT) involves the use of photosensitizing agents for treatment of malignant disease. PDT is approved by the U.S. Food and Drug Administration for the endobronchial microinvasive nonsmall cell lung cancer and for palliation in patients with obstructing tumors. We report our experience and results of PDT in lung cancer. Method : Ten patients with lung cancer who were diagnosed in Chosun university hospital by histologic confirm through bronchoscopy were included between August 2002 and May 2003. The photosensitizer (Photogem$^{(R)}$, Lomonosov institute of Fine Chemical, Russia/dose 2.0 mg/kg body weight) was injected 48 hours prior to the PDT session. For PDT with the photosensitizer (Photogem$^{(R)}$), Diode LASER system (Biolitec Inc., Germany, wavelength; 633nm) were used. PDTs were done at 48-72 hours after photogem injection. Follow up bronchoscopy and chest X-ray or thorax computerized tomography were done for evaluate PDT response. Results : 9 of 10 patients with endobronchial obstruction showed partial remission with bronchus opening after PDT. Direct reaction of the tumor to PDT was similar in despite of its localization. It was as follows; edema, hyperemia, in-situ bleeding, fibrin film occurrence. Any other complications such as sunburns of skin, inflammation within the PDT zone were not occurred by the end of the fourth week. Conclusion : In the advanced endobronchial disease, PDT has been shown to be useful in treating endobronchial tumors that are causing clinically significant dyspnea or are likely to progress and lead to further clinical complications, such as postobstructive pneumonia.

연구배경 : 폐암에서 광역동치료는 미세침습성 비소세포폐암 및 기관지폐쇄를 일으키는 악성종양에 대한 기관지내 치료를 미국식품의약국(FDA)에서 승인한 상태이다. 국내에서는 폐암세포주에 대한 보고 외에 폐암에 대한 광역동치료 연구가 많지 않아 임상 성적에 대한 보고가 없어 이에 저자들은 폐암에서 시행된 광역동치료에 대한 결과를 문헌고찰과 함께 보고하고자 한다. 방 법 : 2002년 8월부터 2003년 5월까지 조선대학교 병원에서 기관지 내시경을 통해 조직학적으로 진단된 폐암환자 중 10명을 대상으로 하여 광역동치료 48시간 전에 광과민제(Photogem$^{(R)}$, Lomonosov institute of Fine Chemical, Russia)를 2.0mg/Kg을 정맥 주사한 후 48시간, 72시간에 Diode LASER system(Biolitec Inc., Germany, wavelength; 633nm)을 사용하여 광역 동치료를 시행하였다. 결 과 : 10명 중 9예에서 부분관해와 함께 기관지 개통을 보였으며, 1예에서는 변화를 보이지 않았다. 결 론 : 저자들은 광역동치료를 통해 기관지폐쇄로 인한 호흡곤란 및 기관지 폐쇄와 관련된 폐렴이 개선됨을 확인 하였으며, 합병증이 적어 안전한 기관지내 치료법으로 생각된다. 앞으로 광역동 치료에 대한 장기적인 결과 및 적절한 치료 적응증 및 조기 폐암에서 치료효과 등에 대한 연구가 필요할 것으로 생각된다.

Keywords

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