ALA光动力诊断导向显微手术与光动力治疗兔脑VX2转移瘤的比较研究

背景与目的：光动力治疗脑胶质瘤是新的疗法之一。实验比较研究光敏剂ALA（5-氨基乙酰丙酸）在光动力诊断（photodynamic diagnosis,PDD）导向显微手术和（或）光动力治疗（photodynamic therapy,PDT）兔脑VX2转移瘤的疗效。方法：50只新西兰大白兔脑内植入VX2瘤块形成移植瘤模型后,随机分为对照组（不治疗）、普通光源显微手术组、单次PDT组、PDD导向显微手术组及PDD导向显微手术辅以PDT组。重点观察比较各组荷瘤动物平均生存期。结果：平均生存期分别为对照组25.20±2.53天、普通光源显微手术组51.40±3.63天、单次PDT组47.40±2.63天、PDD导向显微手术组56.40±3.31天、PDD导向显微手术辅以PDT组58.90±3.28天;与对照组相比,各治疗组的生存期明显延长,以PDD导向显微手术辅以PDT治疗最为显著。结论：单次ALA-PDT可明显延长荷瘤动物生存期;PDD导向显微手术组较普通光源显微手术组显著延长动物生存期;ALA可用于VX2鳞癌脑转移瘤的PDD导向显微手术而且还可用于PDT,ALA-PDD＋PDT可能更有效地治疗VX2脑转移瘤。

Comparative Study on ALA-photodynamic Guiding Microsurgery and Photodynamic Therapy on Implanted VX2 Tumor in Rabbit Intracranial Model

BACKGROND ＆ OBJECTIVE： Photodynamic therapy is one of the new strategies for glioma. The study compared the treatment efficacy of VX2 implanted tumor of rabbit brain by ALA-photodynamic guiding microsurgery and/or photodynamic therapy （PDT）. METHODS： Fifty rabbits with VX2 tumor implanted in the brain were randomized into control group, normal microsurgery group, PDT group, photodynamic guiding microsurgery group and photodynamic guiding microsurgery ＋ PDT group. Mean survival time of five groups were observed. RESULTS： The mean survival time was 25.20 ±2.53 days for control group, 51.40 ±3.63 days for conventional illuminant microsurgery group, 47.40±2.63 days for PDT group, 56.40±3.31days for photodynamic guiding microsurgery group and 58.90±3.28 days for photodynamic guiding microsurgery ＋ PDT group, respectively. Comparing to the control group, the mean survival times were prolonged by therapies, especially by photodynamic guiding microsurgery combined with PDT. CONCLUSIONS： （1） ALA -PDT might improve the mean survival of the rabbits with intracranial VX2 carcinomas significantly. （2） Comparing to conventional microsurgery group, photodynamic guidingmicrosurgery might prolong the mean survival time of the rabbits with VX2 xenografts. （3） ALA can be used for PDT and/or photodynamic guiding microsurgery on the VX2 carcinoma metastatic tumor in the rabbit brain. ALA -photodynamic guiding microsurgery combined PDT might be a potential option in brain metastatic tumor therapy.