Selective accumulation of a photosensitizer and the subsequent response in only the light-irradiated target are advantages of photodynamic diagnosis and therapy. The limited depth of the therapeutic effect is a positive characteristic when treating surface malignancies, such as peritoneal carcinomatosis. For photodynamic diagnosis (PDD), adjunctive use of aminolevulinic acid- protoporphyrin IX-guided fluorescence imaging detects cancer nodules, which would have been missed during assessment using white light visualization only. Furthermore, since few side effects have been reported, this has the potential to become a vital component of diagnostic laparoscopy. A variety of photosensitizers have been examined for photodynamic therapy (PDT), and treatment protocols are heterogeneous in terms of photosensitizer type and dose, photosensitizer-light time interval, and light source wavelength, dose, and dose rate. Although several studies have suggested that PDT has favorable effects in peritoneal carcinomatosis, clinical trials in more homogenous patient groups are required to identify the true benefits. In addition, major complications, such as bowel perforation and capillary leak syndrome, need to be reduced. In the long term, PDD and PDT are likely to be successful therapeutic options for patients with peritoneal carcinomatosis, with several options to optimize the photosensitizer and light delivery parameters to improve safety and efficacy.

中文翻译：

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胃肠道癌腹膜癌的光动力诊断和治疗：现状、机遇和挑战


光敏剂的选择性积累以及仅在光照射目标中的随后反应是光动力诊断和治疗的优点。在治疗腹膜癌病等表面恶性肿瘤时，治疗效果的深度有限是一个积极的特征。对于光动力诊断 (PDD)，辅助使用氨基乙酰丙酸-原卟啉 IX 引导的荧光成像可检测癌结节，而仅使用白光可视化进行评估时可能会漏掉这些结节。此外，由于几乎没有副作用的报道，这有可能成为诊断性腹腔镜检查的重要组成部分。多种光敏剂已被用于光动力治疗（PDT），并且治疗方案在光敏剂类型和剂量、光敏剂-光时间间隔以及光源波长、剂量和剂量率方面存在差异。尽管一些研究表明 PDT 对腹膜癌病具有良好的效果，但需要在更多同质患者群体中进行临床试验才能确定真正的益处。此外，还需要减少主要并发症，例如肠穿孔和毛细血管渗漏综合征。从长远来看，PDD 和 PDT 可能是腹膜癌患者的成功治疗选择，有多种选择可以优化光敏剂和光传输参数，以提高安全性和疗效。