biophBiomedical PhotonicsBiomedical Photonics2413-9432Non-profit partnership for development of domestic photodynamic therapy and photodiagnosis10.24931/2413-9432-2023-12-3-25-35bioph-606Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSФотодинамическая терапия в нейроонкологииPhotodynamic therapy in neurooncologyОлюшинВ. Е.OlyushinV. E.

Санкт-Петербург

St. Petersburg

КукановК. К.KukanovK. K.

Санкт-Петербург

St. Petersburg

НечаеваА. С.NechaevaA. S.

Санкт-Петербург

St. Petersburg

nechaeva_as@almazovcentre.ruСклярС. С.SklyarS. S.

Санкт-Петербург

St. Petersburg

ВершининА. Э.VershininA. E.

Санкт-Петербург

St. Petersburg

ДиконенкоМ. В.DikonenkoM. V.

Санкт-Петербург

St. Petersburg

ГоликоваА. С.GolikovaA. S.

Санкт-Петербург

St. Petersburg

МансуровА. С.MansurovA. S.

Санкт-Петербург

St. Petersburg

СафаровБ. И.SafarovB. I.

Санкт-Петербург

St. Petersburg

РындаА. Ю.RyndaA. Y.

Санкт-Петербург

St. Petersburg

ПапаянГ. В.PapayanG. V.

Санкт-Петербург

St. Petersburg

«Российский научно-исследовательский нейрохирургический институт имени проф. А.Л. Поленова» – филиал ФГБУ «НМИЦ им. В.А. Алмазова» Минздрава РоссииРоссияPolenov Neurosurgical Research Institute, branch of the Almazov National Medical Research CentreRussian Federation«Российский научно-исследовательский нейрохирургический институт имени проф. А.Л. Поленова» – филиал ФГБУ «НМИЦ им. В.А. Алмазова» Минздрава России; Научный центр мирового уровня «Центр персонализированной медицины» ФГБУ «НМИЦ им. В.А. Алмазова» Минздрава РоссииРоссияPolenov Neurosurgical Research Institute, branch of the Almazov National Medical Research Centre; World-Class Research Centre for Personalized MedicineRussian Federation«НМИЦ им. В.А. Алмазова» Минздрава РоссииРоссияAlmazov National Medical Research CentreRussian Federation2023231020231232535Copyright © Олюшин В.Е., Куканов К.К., Нечаева А.С., Скляр С.С., Вершинин А.Э., Диконенко М.В., Голикова А.С., Мансуров А.С., Сафаров Б.И., Рында А.Ю., Папаян Г.В., 20232023Олюшин В.Е., Куканов К.К., Нечаева А.С., Скляр С.С., Вершинин А.Э., Диконенко М.В., Голикова А.С., Мансуров А.С., Сафаров Б.И., Рында А.Ю., Папаян Г.В.Olyushin V.E., Kukanov K.K., Nechaeva A.S., Sklyar S.S., Vershinin A.E., Dikonenko M.V., Golikova A.S., Mansurov A.S., Safarov B.I., Rynda A.Y., Papayan G.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pdt-journal.com/jour/article/view/606

Выполнен обзор литературы, отражающий современное состояние и степень разработанности  методики интраоперационной  фотодинамической терапии (ФДТ) в нейроонкологи. Представлены к обсуждению результаты наиболее значимых исследований, посвященных ФДТ в нейроонкологии. Проведен анализ научных публикаций по данной тематике в базах данных Pubmed, EMBASE, Cochrane Library и eLibrary, опубликованных в промежуток времени с января 2000 г. по декабрь 2022 г. Найдено 204 публикации в зарубежных источниках  и 59 публикаций в отечественных  изданиях, в которых рассматриваются  вопросы применения ФДТ в нейроонкологии. Анализ литературы показал, что в клинической практике интраоперационная  ФДТ в нейроонкологии  является важным инструментом, способствующим увеличению радикальности операции и локального контроля. Фундаментальное обоснование эффективности ФДТ заключается в изучении путей, ведущих к полной девитализации злокачественной  опухоли, изучении механизмов локального и системного  иммунного ответа. При этом субклеточные  мишени при ФДТ обусловлены свойствами  фотосенсибилизаторов (ФС). В многочисленных  исследованиях  показана противоопухолевая эффективность  использования  ФДТ с ФС на основе  хлорина  е6, 5-аминолевулиновой  кислоты, производных  порфиринов.  Установлены механизмы действия и мишени этих ФС. В России  в ряде исследований подтверждена клиническая эффективность  ФДТ у групп нейроонкологических пациентов с глиальным опухолями и вторичными метастатическими опухолями, однако до сих пор метод не включён в клинические рекомендации по оказанию высокотехнологичной  нейрохирургической помощи. Безусловно, необходима дальнейшая разработка методики ФДТ в нейроонкологии, особенно у пациентов с высоким риском рецидива и агрессивными опухолями ЦНС.

Literature review reflects the current status and development status of intraoperative photodynamic therapy in neurooncology and discusses the results of the most important studies on photodynamic  therapy (PDT). We searched the Pubmed, EMBASE, Cochrane Library and eLibrary data-bases for publications  published  between January 2000 and December 2022. Found 204 publications  in foreign sources and 59 publications  in domestic editions, dealing with the issues of photodynamic  therapy in neurooncology. An analysis of the literature has shown that intraoperative PDT in neurooncology is an important tool that contributes to increasing the radicality of the operation and local control. The basic rationale for the effectiveness of PDT lies in the study of the pathways leading to the complete devitalization of a malignant tumor, the study of the mechanisms of the local and systemic immune response. In addition, subcellular targets in PDT are determined by the properties of photosensitizers (PS). Second generation PSs have already been introduced into clinical practice. The effectiveness of PDT using photoditazine, 5-aminolevulinic acid has been demonstrated. The mechanisms of action and targets of these PS have been established. In Russia, a number of studies have repeatedly shown and proved the clinical effectiveness of PDT in groups of neurooncological patients with glial tumors and secondary metastatic tumors, but so far, the method has not been included in the clinical guidelines for the provision of high-tech neurosurgical care. There is certainly a need for further development of PTD techniques in neurooncology, especially in patients at high risk of recurrence and aggressive CNS tumors.

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(In Russian)

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