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KMID : 0614720070500121119
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Journal of Korean Medical Association
2007 Volume.50 No. 12 p.1119 ~ p.1129
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Photodynamic Therapy
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Jheon Sang-Hoon
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Abstract
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Clinical photodynamic therapy was introduced in the 1970s and has been shown to be an
effective treatment modality in a variety of fields in oncology. Photodynamic therapy (PDT) is
a local therapy such as radiation and surgery, which involves the photosensitization of neoplastic
cells and tissues with porphyrins or related structures that catalyze, upon irradiation by laser,
formation of reactive oxygen species. A photosensitizing agent is administered to the patient and
after a period of 24-72 h when the concentration of the photosensitizer is maximized in tumor
tissue compared with normal tissue, and then the neoplastic mass is exposed to the laser light,
which initiates the necrotic process. Despite the ability of PDT to destroy the tumor selectively, it
has not been applied widely due to the lack of understanding of its therapeutic mechanism and
clinical experiences as well as some limitations of currently available photosensitizers. Nowadays,
the number of scientific articles on PDT, regarding clinical applications as well as basic
science, made its application increasing. In one of the most suitable indications, lung cancer,
PDT is a minimally invasive therapeutic option for the treatment of early cancer in airway and
palliation for the endobronchial obstruction from central lung cancer. In esophageal cancer, PDT
can also be applied to treat in early stage without muscle invasion or remnant cancer after
endoscopic mucosal resection. Besides, PDT can be applied as a part of combined modality
such as a neoadjuvant or adjuvant PDT. With the advances of new sensitizers and energy
delivery system, clinical application of PDT will expand in near future. This review article will
focus on the basic mechanism and the clinical investigations of PDT for the clinicians.
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KEYWORD
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Photodynamic therapy, Photodynamic diagnosis, Laser, Photosensitizer, Cancer
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