Download PDF
Pneumologie 2000; 54(7): 269-277
DOI: 10.1055/s-2000-4451
ÜBERSICHT
Georg Thieme Verlag Stuttgart · New York

Photodynamische Therapie in der Pneumologie

F. Stanzel1 , K. Häußinger1 , D. Geiger1 , J. Pichler2 , W. Sauer1 , H. Stepp2
  • 1Asklepios Fachkliniken München-Gauting, Pneumologische Klinik (Chefarzt: Prof. Dr. K. Häußinger)
  • 2Laser-Forschungslabor, Urologische Klinik und Poliklinik, Klinikum Großhadern, Ludwig-Maximilians-Universität München (Direktor: Prof. Dr. A. Hofstetter)
Further Information

Publication History

Publication Date:
31 December 2000 (online)

Also available at
   Permissions and Reprints

Einleitung

Die photodynamische Therapie (PDT) ist ein endoskopisches Behandlungsverfahren, das in den letzten 20 Jahren in spezialisierten Zentren zunehmend zur kurativen Therapie des oberflächlich wachsenden Bronchialkarzinoms eingesetzt wird. Sie basiert auf der Anwendung einer tumoraffinen Substanz, die durch Licht einer spezifischen Wellenlänge aktiviert wird [[1]]. Die dadurch ausgelöste photooxidative Reaktion führt zum Zelltod durch Gefäßverschlüsse mit Hypoxie und sekundärer Tumornekrose, während normales Gewebe nicht oder nur geringfügig reagiert [[1], [2]].

Literatur

  • 1 Dougherty T J, Gomer C J, Henderson B W, Jori G, Kessel D, Korbelik M, Moan J, Peng Q. Photodynamic therapy.  J Natl Cancer Inst. 1998;  90 889-905
    CrossrefPubMedGoogle Scholar
  • 2 Edell E S, Cortese D A. Photodynamic Therapy - Its Use in the Management of Bronchogenic Carcinoma.  Clin Chest Med. 1995;  16 455-463
    PubMedGoogle Scholar
  • 3 Raab O. Über die Wirkung fluorescierender Stoffe.  Infusoria Z Biol. 1900;  39 524
    PubMedGoogle Scholar
  • 4 Jesoniek A, von Tappeiner H. Zur Behandlung des Hautcarcinoms mit fluorescierenden Stoffen.  Muench Med Wschr. 1903;  47 2043
    PubMedGoogle Scholar
  • 5 Lipson R L, Baldes E J, Olsen A M. The use of a derivative of hematoporphyrin in tumor detection.  J Natl Cancer Inst. 1961;  26 1-11
    PubMedGoogle Scholar
  • 6 Lipson R L, Baldes E J. The photodynamic properties of a particular hematoporphyrin derivative.  Arch Dermatol. 1960;  82 508-516
    PubMedGoogle Scholar
  • 7 Cortese D A, Edell E S, Kinsey J H. Photodynamic therapy for early stage squamous cell carcinoma of the lung.  Mayo Clin Proc. 1997;  72 595-602
    PubMedGoogle Scholar
  • 8 Kato H, Konaka C, Kawate N, Shinohara H, Kinoshita K, Noguchi M, Ootomo S, Hayata Y. Five-year disease-free survival of a lung cancer patient treated only by photodynamic therapy.  Chest. 1986;  90 768-770
    PubMedGoogle Scholar
  • 9 Häußinger K, Stanzel F, Sauer W. Photodynamic therapy of inoperable patients with early stage lung cancer. Abstract. World Congress for Bronchology June 1998: 118
  • 10 Häußinger K, Stanzel F, Nimmermann C, Huber R M, Baumgartner R. Hämatoporphyrinderivate in der Therapie: Momentane Erkenntnisse und Ausblicke für die Zukunft.  Atemw Lungenkrkh. 1996;  22 295-300
    PubMedGoogle Scholar
  • 11 Wieman T J, Diaz-Jiménez J P, Moghissi K, Leroy M, McCaughan J, Spinelli P, Lang N, Diaz-Agero P, York E. The Photodynamic Therapy Lung Cancer Study Group Louisville, KY, USA/Barcelona, Spain. Photodynamic therapy (PDT) with Photofrin is effective in the palliation of obstructive endobronchial lung cancer. Results of two clinical trials (abstract). ASCO. 1998
  • 12 Levy J. Photosensitizers in photodynamic therapy.  Semin Oncol. 1994;  21 4-10
    PubMedGoogle Scholar
  • 13 Kessel D. PDT: Expanding the Database. An Update on New Drugs and Mechanisms of Phototoxicity.  Photodynamic News. 1998;  1 2-4
    PubMedGoogle Scholar
  • 14 Baumgartner R, Huber R M, Schulz H, Stepp H, Rick K, Gamarra F, Leberig A, Roth C. Inhalation of 5-aminolevulinic acid: A new technique for fluorescence detection of early stage lung cancer.  J Photochem Photobiol B. 1996;  36 169-174
    CrossrefPubMedGoogle Scholar
  • 15 Oleinick N L. Apoptosis in Response to Photodynamic Therapy.  Photodynamic News. 1998;  1 6-9
    PubMedGoogle Scholar
  • 16 Edell E S, Cortese D A. Potentiation of hemato prophyrin derivative photoherapy with adriamycin. Porphyrin photosensitization Workshop. Abstract from IPA Los Angeles. July 1986: 15
  • 17 Cowled P A, Maekenzie L, Forbes M. Potentiation of photodynamic therapy with haematoporphyrin derivatives by glucocorticoids.  Cancer Lett. 1986;  29 101-114
    PubMedGoogle Scholar
  • 18 Edell E S, Cortese D A. Interaction between glucocorticosteroids and hematoporphyrin derivative phototherapy. Porphyrin photosensitization Workshop (abstract). Los Angeles; IPA July 1986: 16
  • 19 Awadh N, MacAulay C, Lam S. Detection and Treatment of Superficial Lung Cancer by Using δ-Aminolevulinic Acid: A Preliminary Report.  J Bronchol. 1997;  4 13-17
    PubMedGoogle Scholar
  • 20 Hayata Y, Kato H, Konaka C, Ono J, Takizawa N. Hematoporphyrin derivative and laser photoradiation in the treatment of lung cancer.  Chest. 1982;  81 269-277
    PubMedGoogle Scholar
  • 21 Hayata Y. The indications of photodynamic therapy in early stage lung cancer (abstract).  Chest. 1993;  103 262
    PubMedGoogle Scholar
  • 22 Häußinger K, Pichler J, Stanzel F, Markus A, Stepp H, Morresi-Hauff A, Baumgartner R. Autofluorescence Bronchoscopy: The D-Light System. Aus Bollinger CT, Mathur PN (Editors) Interventional Bronchology. Prog Respir Res. Basel: Karger 2000 30: 243-252
    Google Scholar
  • 23 Häußinger K, Stanzel F, Huber R M, Pichler J, Stepp H. Autofluorescence detection of bronchial tumors with the D-Light/AF:.  Diagn Ther Endosc. 1999;  5 105-112
    PubMedGoogle Scholar
  • 24 Häußinger K, Stanzel F, Markus A, Bolliger C T, Pichler J. Frühdiagnostik des Bronchialkarzinoms. Technisch-endoskopische Neuentwicklungen - ein Anstoß für ein neues Screening-Konzept.  Pneumologie. 1999;  53 77-82
    PubMedGoogle Scholar
  • 25 Becker H D, Messerschmidt E, Schindelbeck F, Ott S. Endobronchialer Ultraschall.  Pneumologie. 1997;  51 620-629
    PubMedGoogle Scholar
  • 26 Cortese D A, Pairolero P C, Bergstrahl E J, Woolner L B, Uhlenkopp M A, Piehler J M, Sanderson D R, Bernatz P E, Williams D E, Taylor W F, Payne W S, Fontana R S. Roentgenographically occult lung cancer. A ten-year experience.  J Thorac Cardiovasc Surg. 1983;  86 373-380
    PubMedGoogle Scholar
  • 27 Gross N J. Pulmonary effects of radiation therapy.  Ann Intern Med. 1977;  86 81-92
    PubMedGoogle Scholar
  • 28 Okunaka T, Kato H, Konaka C, Kawate N, Bonaminio A, Yamamoto H, Ikeda N, Tolentino M, Eckhauser M L, Hayata Y. Photodynamic therapy for multiple primary bronchogenic carcinoma.  Cancer. 1991;  68 253-258
    PubMedGoogle Scholar
  • 29 Pairolero P C, Williams D E, Bergstrahl E J. et al . Postsurgical stage 1 bronchogenic carcinoma: Morbid implications of recurrent disease.  Ann Thorac Surg. 1984;  38 331-338
    CrossrefPubMedGoogle Scholar
  • 30 Prakash U BS. Options in the Bronchoscopic Therapy of Airway Neoplasms.  Editorial. J Bronchol. 1997;  4 97-100
    PubMedGoogle Scholar
  • 31 Sutedja G, Postmus P E. Bronchoscopic treatment of lung tumors.  Lung Cancer. 1994;  11 1-17
    PubMedGoogle Scholar
  • 32 Edell E S, Cortese D A. Bronchoscopic phototherapy with hematoporphyrin derivative for treatment of localized bronchogenic carcinoma: A 5-year experience.  Mayo Clin Proc. 1987;  62 8-14
    PubMedGoogle Scholar
  • 33 Edell E S, Cortese D A. Photodynamic therapy in the management of early superficial squamous cell carcinoma as an alternative to surgical resection.  Chest. 1992;  102 1319-1322
    CrossrefPubMedGoogle Scholar
  • 34 Furuse K, Fukoka M, Kato H. et al . A prospective phase II study on photodynamic therapy with Photofrin for centrally located early stage lung cancer.  J Clin Oncol. 1993;  11 1852-1857
    PubMedGoogle Scholar
  • 35 Hayata Y, Kato H, Furuse K, Kusunoki Y, Suzuki S, Nimura S. Photodynamic therapy of 168 early stage cancers of the lung and oesophagus: A japanese multicenter study.  Lasers Med Sci. 1996;  11 255-259
    PubMedGoogle Scholar
  • 36 Hayata Y, Kato H, Konaka C. Photodynamic therapy (PDT) in early stage lung cancer.  Lung Cancer. 1993;  9 287-294
    CrossrefPubMedGoogle Scholar
  • 37 Imamura S, Kusunoki Y, Takifuji N. et al . Photodynamic therapy and/or external beam radiation therapy for roentgenologically occult lung cancer.  Cancer. 1994;  73 1608-1614
    PubMedGoogle Scholar
  • 38 Konaka C, Kato H, Havata Y. Lung cancer treated by photodynamic therapy alone: Survival for more than three years.  Lasers Med Sci. 1987;  2 17-19
    PubMedGoogle Scholar
  • 39 McCaughan J S, Hawley Ph C, Bethel B H, Walker J. Photodynamic therapy of endobronchial malignancies.  Cancer. 1988;  62 691-701
    PubMedGoogle Scholar
  • 40 McCaughan J S, Williams T E. Photodynamic therapy for endobronchial malignant disease: A prospective fourteen-year study.  J Thorac Cardiovasc Surg. 1997;  114 940-947
    CrossrefPubMedGoogle Scholar
  • 41 Monnier P H, Savary M, Fontollet Ch, Wagnieres G, Chatelain A, Comaz P, Depeursinge Ch, van den Bergh H. Photodetection and photodynamic therapy of “early” squamous cell carcinomas of the pharynx, oesophagus and tracheobronchial tree.  Lasers Med Sci. 1990;  5 149-169
    PubMedGoogle Scholar
  • 42 Sutedja G, Lam S, LeRiche C, Postmus P E. Response and pattern of failure after photodynamic therapy for intraluminal stage I lung cancer.  J Bronchol. 1994;  1 295-298
    PubMedGoogle Scholar
  • 43 Lam S, Häußinger K, Leroy M, Sutedja T, Huber R M. Photodynamic therapy (PDT) with Photofrin, a treatment with curative potential for early stage superficial lung cancer (abstract). ASCO 1998
  • 44 Sobue T, Suzuki T, Matsuda M, Kuroishi T, Ikeda S, Naruke T. Survival for clinical stage I lung cancer not surgically treated.  Cancer. 1992;  69 685-692
    PubMedGoogle Scholar
  • 45 Dosoretz D E, Katin M J, Blitzer P H, Rubenstein J H, Salenius S, Rashid M, Dosani R A, Mestas G, Siegel A D, Chadha T T. Radiation therapy in the management of medically inoperable carcinoma of the lung: Results and implications for future treatment strategies.  Int J Radiat Oncol Biol Phys. 1992;  24 3-9
    CrossrefPubMedGoogle Scholar
  • 46 Haffty B G, Goldberg M B, Gerstley J, Fischer D B, Peschel R-E. Results of radical radiation therapy in clinical stage I, technically operable non-small cell lung cancer.  Int J Radiat Oncol Biol Phys. 1988;  15 69-73
    PubMedGoogle Scholar
  • 47 Ono R, Egawa S, Suemasu K, Sakusa M, Kitogawa T. Radiotherapy for inoperable stage I lung cancer.  Jpn J Clin Oncol. 1991;  21 125-128
    PubMedGoogle Scholar
  • 48 Sandler H M, Curran W J, Turrisi A T. The influence of tumor size and treatment staging on outcome following radiation therapy alone for stage I non small cell lung cancer.  Int J Radiat Oncol Bio Phys. 1990;  19 9-13
    PubMedGoogle Scholar
  • 49 Slotman B J, Njo K H, Karim A B. Curative radiotherapy for technically operable stage I non-small cell lung cancer.  Int J Radiat Oncol Biol Phys. 1994;  29 33-37
    CrossrefPubMedGoogle Scholar
  • 50 Freitag L, Korupp A, Itzigehl I, Dankwart F, Tekolf E, Reichle G, Kullmann H J. Erfahrungen mit Fluoreszenzdiagnostik und photodynamischer Therapie im multimodalen Therapiekonzept des operierten, rezidivierenden Bronchialkarzinoms.  Pneumologie. 1996;  50 693-699
    PubMedGoogle Scholar
  • 51 Kato H, Konaka C, Ono J, Kawate N, Nishimiya K, Shinohara H, Saito M, Sakai H, Noguchi M, Kito T. Preoperative laser photodynamic therapy in combiantion with operation in lung cancer.  J Thorac Cardiovasc Surg. 1985;  90 420-429
    PubMedGoogle Scholar
  • 52 Carroll M, Morgan S A, Yamold J R, Hill J M, Wright N M. Prospective evaluation of a watch policy in patients with inoperable non-small cancer.  Eur J Cancer Clin Oncol. 1986;  22 1352-1356
    PubMedGoogle Scholar
  • 53 Bölcskei P L, Dierkesmann R, Becker H D, Bolliger C T, Frank W, Freitag L, Gottschall D A, Häußinger K, Huber R, Kirsten D, Kreuzer A, Loddenkemper R, Macha H N, Mäder I, Mall W, Morr H, Nakhosteen J, Strausz J, Tekolf E, Wagner M, Wilkens H, Witt C. Empfehlungen zur bronchoskopischen Behandlung tracheobronchialer Verschlüsse, Stenosen und muraler maligner Tumoren.  Pneumologie. 1998;  52 243-248
    PubMedGoogle Scholar
  • 54 Personne C, Colchen A, Leroy M, Vourc'h G, Toty L. Indications and technique for endoscopic laser resections in bronchology. A critical analysis based upon 2.284 resections.  J Thorac Cardiovasc Surg. 1986;  91 710-715
    PubMedGoogle Scholar
  • 55 Diaz-Jiménez J P, Martínez-Ballarín J E, Llunell A, Farrero E, Rodríguez A, Castro M J. Efficacy and safety of photodynamic therapy versus Nd-YAG laser resection in NSCLC with airway obstruction.  Eur Respir J. 1999;  14 800-805
    CrossrefPubMedGoogle Scholar
  • 56 McCaughan Jr J S, Williams Jr T E, Bethel B H. Photodynamic therapy of endobronchial tumors.  Lasers Surg Med. 1986;  6 336-345
    PubMedGoogle Scholar
  • 57 Lam S, Cory P. Combined photodynamic therapy (PDT) using Photofrin and radiotherapy (XRT) versus radiotherapy alone in patients with inoperable distribution of non-small cell bronchogenic cancer.  Proc SPIE. 1991;  5 20-28
    PubMedGoogle Scholar
  • 58 Dachowski L J, DeLaney T F. Photodynamic therapy: The NCI experience and its nursing implications.  Oncol Nurs Forum. 1992;  19 63-67
    PubMedGoogle Scholar
  • 59 Cortese D A. Photodynamic Therapy for Early Stage Lung Cancer: A Treatment in Search of a Disease.  Editorial. J Bronchol. 1997;  4 3-4
    PubMedGoogle Scholar
  • 60 Balchum O J, Doiron D R. Photoradiation therapy of endobronchial lung cancer: Large obstructing tumors, non-obstructing tumors, early stage bronchial cancer lesions.  Clin Chest Med. 1985;  6 255-275
    PubMedGoogle Scholar
  • 61 Huber R M, Gamarra F, Hautmann H, Häußinger K, Wagner S, Castro M, Baumgartner R. 5-Aminolaevulinic Acid (ALA) for the Fluorescence Detection of Bronchial Tumors.  Diagn Ther Endosc. 1999;  5 113-118
    PubMedGoogle Scholar
  • 62 Huber R M, Gamarra F, Leberig A, Stepp H, Rick K, Häußinger K, Baumgartner R. Stellenwert der Fluoreszenzmethoden in der bronchologischen Diagnostik: Früherkennung des Bronchialkarzinoms möglich.  Atemw Lungenkrkh. 1995;  21 558-561
    PubMedGoogle Scholar
  • 63 Kato H. Photodynamic therapy for early stage central type of lung cancer - Editorial.  Chest. 1997;  72 688-690
    PubMedGoogle Scholar
  • 64 Lam S. Photodynamic therapy in lung cancer.  Semin Oncol. 1994;  21 15-19
    PubMedGoogle Scholar
  • 65 LoCicero J, Metzdorff M, Almgren C. Photodynamic therapy in the palliation of late stage obstructing non-small cell lung cancer.  Chest. 1990;  98 97-100
    CrossrefPubMedGoogle Scholar
  • 66 McCaughan J S. Photodynamic Therapy versus Nd-YAG laser treatment of endobronchial or esophageal malignancies; in Photodynamic Therapy and Biomedical Lasers. Proceedings of the International Conference on Photodynamic Therapy and Medical Laser Applications. Milan; 1992: 23-36
  • 67 Reynolds T. Using lasers and light-activated drugs, researches home in on early lung cancers.  J Natl Cancer Inst. 1998;  90 411-418
    PubMedGoogle Scholar

Dr. med F Stanzel

Asklepios Fachkliniken München-Gauting Pneumologische Klinik

Robert-Koch-Allee 2 82131 Gauting

Email: E-mail: fstanzel@t-online.de

      >