Uloga fotodinamske terapije u liječenju karcinoma probavnog sustava

The discovery that particular substances can cause photosensitivity is attributed to Oscar Raab, however, the modern era of photodynamic therapy was established by Dr. T.J. Dougherty from Buffalo Memorial Institute. He was the first to report that a systemically injected porphyrin (hematoporphyrin), when activated by red light, caused complete eradication of transplanted experimental tumors. He also was the first to demonstrate the preferential accumulation of the photosensitizer in malignant cells. The first clinical application of photodynamic therapy was in 1980 at the Tokyo Medical College in a patient with a small upper bronchial squamous cell tumor, treated at bronchoscopy with photodynamic therapy using a laser as the light source. The tumor was completely eradicated. Simultaneously, a case of large obstructing esophageal cancer similarly treated with photodynamic therapy with good relief of dysphagia and prolonged survival was reported. The current state-of-the-art and results recorded in the clinical use of photodynamic therapy in the management of gastrointestinal malignancies are presented.Otkriće da određene tvari mogu uzrokovati fotosenzitivnost pripisuje se Oscaru Raabu, međutim, ocem moderne ere fotodinamske terapije smatra se T. J. Dougherty s Instituta Buffalo Memorial. On je naime prvi objavio da sistemski dan porfirin (hematoporfirin), kada se aktivira crvenom svjetlošću, uzrokuje potpuno uništenje transplantiranog eksperimentalnog tumora. Također je prvi otkrio i objavio da fotosenzibilizirajuće tvari imaju sklonost nakupljanju u malignim stanicama. Prvi slučaj kliničke primjene fotodinamske terapije učinjen je na Tokyo Medical Collegeu 1980. godine. Bolesnik s malim skvamoznim tumorom gornjeg bronha bio je bronhoskopski podvrgnut fotodinamskoj terapiji, pri čemu se kao izvor svjetlosti rabio laser, a rezultat je bio potpuna eradikacija tumora. Istodobno je objavljen slučaj kliničke primjene fotodinamske terapije kao palijacijske metode u bolesnika s velikim karcinomom jednjaka, što je dovelo do uklanjanja disfagije te produžilo bolesnikov život. Ovaj rad prikazuje dosadašnje spoznaje i rezultate kliničke primjene fotodinamske terapije u liječenju malignih bolesti probavnog sustava