biophBiomedical PhotonicsBiomedical Photonics2413-9432Non-profit partnership for development of domestic photodynamic therapy and photodiagnosis10.24931/2413-9432-2020-9-1-34-41bioph-403Research ArticleОБЗОРЫREVIEWSВозможности фотодинамической терапии при эритроплазии КейраPhotodynamic therapy opportunities for the treatment of erythroplasia of QueyratКапринА. Д.KaprinA. D.

Москва

Moscow

Иванова-РадкевичВ. И.Ivanova-RadkevichV. I.

Москва

Moscow

ivanova-radkevich-vi@rudn.ruУрловаА. Н.UrlovaA. N.

Москва

Moscow

АсратовА. Т.AsratovA. T.

Москва

Moscow

ГущинаЮ. Ш.GushchinaYu. Sh.

Москва

Moscow

LiboL.LiboL.

Guangzhou, Guangdong

Guangzhou, Guangdong

XiaojunC.XiaojunC.

Guangzhou, Guangdong

Guangzhou, Guangdong

ФилоненкоЕ. В.FilonenkoE. V.

Москва

Moscow

МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИЦР» Минздрава РФ; Российский Университет дружбы народовРоссияP.A. Herzen Moscow Oncology Research Center – branch of FSBI NMRRC of the Ministry of Health of Russia; Peoples’ Friendship University of Russia (RUDN University)Russian FederationРоссийский Университет дружбы народовРоссияPeoples’ Friendship University of Russia (RUDN University)Russian FederationМНИОИ им. П.А. Герцена – филиал ФГБУ «НМИЦР» Минздрава РФРоссияP.A. Herzen Moscow Oncology Research Center – branch of FSBI NMRRC of the Ministry of Health of RussiaRussian FederationCancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical UniversityКитайCancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical UniversityChina202023042020913441Copyright © Каприн А.Д., Иванова-Радкевич В.И., Урлова А.Н., Асратов А.Т., Гущина Ю.Ш., Libo L., Xiaojun C., Филоненко Е.В., 20202020Каприн А.Д., Иванова-Радкевич В.И., Урлова А.Н., Асратов А.Т., Гущина Ю.Ш., Libo L., Xiaojun C., Филоненко Е.В.Kaprin A.D., Ivanova-Radkevich V.I., Urlova A.N., Asratov A.T., Gushchina Y.S., Libo L., Xiaojun C., Filonenko E.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pdt-journal.com/jour/article/view/403

Обзор посвящен анализу эффективности лечения эритроплазии Кейра методом фотодинамической терапии (ФДТ). Особое внимание уделено вопросам взаимосвязи эритроплазии Кейра с инфицированием вирусом папилломы человека (ВПЧ). Приведены данные исследований, подтверждающие корреляцию между развитием заболевания и инфицированием ВПЧ, отмечено, что в связи с небольшим количеством исследований сложно делать достоверные выводы о наличии и силе этой связи. Рассмотрены механизмы ФДТ, участвующие в реализации как противоопухолевого эффекта при лечении эритроплазии Кейра, так и противовирусного действия в отношении ВПЧ. Проанализированы данные 12 клинических исследований и наблюдений результатов ФДТ при эритроплазии Кейра, проведенных в последние годы. Установлено, что при лечении заболевания, как правило, используют местно один из двух фотосенсибилизаторов: 5-аминолевулиновую кислоту (5-АЛК) или ее метиловый эфир. Параметры лечения во всех исследованиях были близки: экспозиция мази продолжительностью от 3 до 5 ч с последующим облучением со световой дозой 37 - 105 Дж/см2 . Количество курсов ФДТ в разных исследованиях составляло от 1 до 19. Эффективность лечения широко варьировала в разных исследованиях и клинических наблюдениях. Большинство исследований демонстрировало высокую эффективность ФДТ с полной регрессией образования в 36 - 83% наблюдений и продолжительностью безрецидивного периода до 51 мес. Имелись и отдельные клинические наблюдения, в которых ФДТ оказалась неэффективна. Возможно, описанные результаты были связаны с неправильно подобранными режимами ФДТ или большой площадью поражения. Большинство авторов отмечают хороший косметический эффект ФДТ и полное отсутствие рубцов после проведенного лечения. Таким образом, ФДТ является эффективным и перспективным методом лечения эритроплазии Кейра, однако, требующим тщательной отработки режимов применения и более глубокого изучения противоопухолевого и противовирусного компонентов механизма действия.

The review is dedicated to the analysis of the effectiveness of the treatment of erythroplasia of Queyrat (EQ) using photodynamic therapy (PDT). Particular attention is paid to the relationship between EQ and human papillomavirus (HPV) infection. The data of various researchers are presented, confirming the correlation between the development of the EQ and the HPV infection, however, it is noted that due to the small number of studies it is difficult to draw reliable conclusions on the presence and strength of this connection. The mechanisms of PDT involved in the implementation of both the antitumor effect in the treatment of EQ and the antiviral effect against HPV are considered. The data of 12 clinical studies and observations of the results of PDT of the EQ conducted in recent years are analyzed. An analysis of literature data showed that in the treatment of EQ, one of the two photosensitizers is usually used locally: 5-aminolevulinic acid or 5-aminolevulinic acid methyl ester. The treatment parameters in all the analyzed studies were similar: exposure to the ointment for 3–5 hours followed by irradiation with a light dose of 37–105 J/cm2. The number of PDT courses in different studies varied from 1 to 19. The effectiveness of treatment varied widely in different studies and clinical observations. Most studies have demonstrated high efficacy of PDT with complete regression in 36–83% (100% in one study) and a relapse-free follow-up period of up to 51 months. However, there were also individual clinical observations of patients in whom the treatment with the method of PDT was ineffective. It is possible that the described results were associated with improperly selected regimes of PDT or a large lesion area. Most authors especially note a very good cosmetic effect and a complete absence of scars after the treatment. Thus, PDT is an effective and promising method for the treatment of EQ that requires, however, a more thorough development of the application regimen and a deeper study of the antitumor and antiviral components of the mechanism of action.

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The authors declare that there are no conflicts of interest present.