Résumé
En gastroentérologie, la thérapie photodynamique (PDT) est un traitement anti-néoplasique qui repose sur la destruction d’un tissu tumoral, sensibilisé par un photosensibilisant administré par voie générale, par une lumière laser. Le Photofrin® (Axcan Pharma, Canada) est le photosensibilisant le plus utilisé. L’illumination laser, sans effet thermique, est délivrée circonférentiellement par un diffuseur cylindrique à l’extrémité d’une fibre optique passée dans le canal opérateur d’un endoscope. Après concertation multidisciplinaire, les cancers superficiels de l’œsophage chez des patients inaccessibles à un autre traitement, avec une récidive post-radiothérapie, la dysplasie sévère en muqueuse de Barrett, et le cholangiocarcinome inopérable, dans le but de prolonger la survie des patients traités palliativement par drainage biliaire, sont ses principales indications. Notre propos est de discuter les modalités et les résultats de la PDT dans le but d’optimiser sa réalisation.
Abstract
In gastroenterology, photodynamic therapy is an anti-neoplastic treatment based on photosensitization of neoplasms, following the administration of a photosensitizer, prior to laser light-induced tissue destruction. Photofrin® (Axcan Pharma, Canada) is the photosensitizer usually used. Light is delivered circumferentially at subthermal threshold rates using cylindrical diffusing quartz fibre, usually passed through the channel of an endoscope under general anaesthesia. After a pluridisciplinary meeting, superficial oesophageal cancers in patients that are unsuitable for any other treatment, with a recurrence after radiotherapy, severe dysplasia in Barrett’s oesophagus and cholangiocarcinoma unfit for surgery, with the aim of prolonging life in patients treated with palliative biliary prosthesis, are its main indications. This paper aims to discuss its modalities and results in order to achieve PDT in the best possible conditions.
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Maunoury, V., Mordon, S., Bulois, P. et al. La thérapie photodynamique en gastroentérologie: quoi de neuf en 2009 ?. Acta Endosc 39, 353–356 (2009). https://doi.org/10.1007/s10190-009-0083-2
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DOI: https://doi.org/10.1007/s10190-009-0083-2