광역동 치료를 이용한 조기 식도암의 근치적 치료 1예
A Case of Photodynamic Therapy as a Curative Treatment of Early Esophageal Cancer
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
조기 식도암의 근치적인 치료로는 외과적 절제술이 이용되나 최근 수술에 대한 합병증, 환자의 삶의 질, 식도의 보존 등을 고려하여 덜 침습적인 방법으로 내시경 치료술이 많이 선택되고 있다. 광역동 치료는 광과민제를 투여 후 광원 전달 장치를 이용하여 광원을 조사하면서 종양을 선택적으로 파괴시키는 방법으로 식도암에 있어서 고식적인 치료뿐만 아니라 근치적인 치료로도 사용되고 있으며, 국내에서는 2004년 8월부터 허가되어 사용되고 있다. 광역동 치료의 국소치료는 림프선 전이가 없는 표재성 식도암에서 근치적인 치료로 기대되고 있다. 저자들은 3년 전 식도암 점막 절제술과 방사선 치료로 완치된 73세 남자의 추적검사에서 새로이 발생된 조기 식도암을 진단하고 페기종과 방사선 섬유증 등의 만성 폐질환으로 수술이 불가능하여 광역동 치료로 성공적인 근치적 치료를 시행하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Although the surgical treatment of early esophageal cancer is a well-known curative modality, less invasive endoscopic methods have attracted significant attention recently on account of the fewer postoperative complications, better quality of life and preservation of the integrity of the esophagus. Among the various endoscopic techniques employed, photodynamic therapy (PDT) has been used to allow the selective destruction of malignant tissue through a photochemical effect after the administration of a photosensitizer for curative and palliative treatment purposes. This report describes a case of a 73-year-old man with early esophageal cancer, which had been diagnosed by fluorodeoxyglucose-positron emission tomography (FDG-PET) and endoscopy and a long history of chronic pulmonary diseases such as emphysema and radiation fibrosis. The patient was cured successfully with photodynamic therapy using porfimer sodium as the photosensitizer. (Korean J Gastrointest Endosc 2006;33:37-41)
참고문헌 (20)
- "Endoscopic treatment of high-grade dysplasia and early stage cancer in Barrett's esophagus", 61, pp.506~514 (2005)
- "Treatment of superficial esophageal cancer", 22, pp.25~31 (2000)
- "Combined-modality therapy for locoregional esophageal cancer", 44, pp.179~185 (2004)
- "Long-term results of photodynamic therapy with 5-aminolevulinic acid for superficial Barrett's cancer and high-grade intraepithelial neoplasia", 62, pp.24~30 (2005)
- "Role of photodynamic therapy in the management of gastrointestinal cancer", 60, pp.1~10 (1999)
- "Uses of photodynamic therapy in premalignant and malignant lesions of the gastrointestinal tract beyond the esophagus", 39, pp.653~664 (2005)
- "Photodynamic therapy and endoscopic metal stent placement for esophageal papillomatosis associated with squamous cell carcinoma", 17, pp.187~190 (2004)
- "Photodynamic therapy for superficial gastrointestinal tumors", 32, pp.61~86 (2006)
- "Endoscopic treatment of high-grade dysplasia and early cancer in Barrett's oesophagus", 6, pp.311~321 (2005)
- "Photodynamic therapy for early oesophageal cancer", 37, pp.491~495 (2005)
- "Photodynamic therapy and endoscopic mucosal resection for Barrett's dysplasia and early esophageal adenocarcinoma", 97, pp.827~830 (2004)
- "Endoscopic mucosal resection for early cancers of the upper gastrointestinal tract", 23, pp.4490~4498 (2005)
- "Optimization of light dosimetry for photodynamic therapy of Barrett's esophagus", 61, pp.13~18 (2005)
- "Photodynamic therapy with green light and m-tetrahydroxyphenyl chlorin for intramucosal adenocarcinoma and high- grade dysplasia in Barrett's esophagus", 59, pp.880~889 (2004)
- "Advances in Barrett's esophagus and esophageal adenocarcinoma", 128, pp.1554~1566 (2005)
- "Photodynamic therapy in gastroenterology", 45, pp.153~161 (2005)
- "Photodynamic therapy with m-tetrahydroxyphenyl chlorin for high-grade dysplasia and early cancer in Barrett's columnar lined esophagus", 62, pp.617~623 (2005)
- "Endoscopic therapeutic esophageal interventions", 21, pp.490~497 (2005)
- "Curative treatment for high-grade intraepithelial neoplasia in Barrett's esophagus", 37, pp.999~1005 (2005)
- "Photodynamic therapy of superficial esophageal cancer with a transparent hood", 60, pp.120~124 (2004)