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INVENTION
Patent of the Russian Federation RU2128533
METHOD OF TREATMENT BY LYMPHME SKIN
The name of the inventor: Gelfond M.L .; Bystrova IM; Gershanovich MA; Ivanov VS; Smirnov V.B.
The name of the patent owner: NII. "Russian Center for Laser Physics" at the St. Petersburg State University
Address for correspondence: 198904, St. Petersburg, Old Peterhof, ul.Ulyanovskaya, 1 NIIRTSLF
Date of commencement of the patent: 1996.04.19
The invention relates to medicine and is intended for the treatment of skin lymphomas. On the affected area of the skin, a preparation containing 0.07-2.0% of a photosensitizer is applied. Withstand for at least 15 minutes. Remove the residue of the drug that is not absorbed into the skin. Then the laser beam is applied. The wavelength is selected in accordance with the absorption spectrum of the photosensitizer. The power density of laser radiation is 1-10 W / cm 2 . The method provides selective destruction of tumor cells without thermal impact on the tumor and healthy skin tissues, while increasing efficacy and shortening the duration of treatment.
DESCRIPTION OF THE INVENTION
The present invention relates to medicine, in particular to methods of treating malignant skin tumors, namely, methods for treating skin lymphomas.
A method for treating malignant tumors by local anesthesia is known, followed by coagulation of the tumor with a CO 2 laser beam (Wheeland RG, Bailin PL, Ratz JL, et al., Cardio dioxide laser vaporization and curettage in the treatm of large or multiple superficial basal cell carcinomas J. Dermatol , Surg., Oncol., 1987; 13: 119-125).
The disadvantages of this method of treatment include the danger of dissemination of tumor elements into healthy tissues during local anesthesia and the probability of incomplete destruction of tumor cells when the tumor is coagulated by a laser beam, which reduces the effectiveness of treatment and does not exclude relapses. In this case, the coagulation of the tumor is associated with the thermal exposure of the laser beam to the skin affected by the tumor, which affects the duration of treatment.
The closest approach is to treat malignant surfaces of tumors by local anesthesia with novocaine, followed by coagulation of the tumor with a CO 2 laser beam, in which, after anesthesia around the tumor node 1.5-2.0 cm away from it, the focused CO 2 laser beam dissects the skin and subcutaneous tissue , And tumor coagulation is carried out with a focused CO 2 laser beam 1.5 - 3.0 mm in diameter with an energy illumination of 200-600 W / cm 2 for 1-10 s (Authorship of the USSR N 629932, A 61 N 5 / 00, published on 30.10.80.).
The disadvantages of this method of treatment include the danger of spreading tumor cells to healthy tissues during local anesthesia with novocaine and the probability of incomplete destruction of tumor cells when the tumor is coagulated by a laser beam, which reduces the effectiveness of treatment and does not exclude relapses. At the same time, the creation of a coagulation shaft around the tumor node at a distance of 1.5-2.0 cm from it and subsequent coagulation of the tumor node and the surrounding healthy tissues confined by the coagulation shaft are associated with thermal exposure to the laser beam both to the skin affected by the tumor, and On healthy skin tissue, which increases the duration of treatment.
The invention is based on the task of creating a method for treating lymphomas of the skin providing therapeutic disruption of tumor cells by exposure to laser radiation without thermal exposure to the tumor and healthy skin tissues, which increases efficacy and shortens the duration of treatment.
Achievement of the above technical result is ensured by the fact that in the treatment of skin lymphomas on the surface of the affected area of the skin, before applying the laser beam, a drug containing 0.07-2.0% of the photosensitizer is applied, held for at least 15 minutes, and then the impure Skin remnants of the preparation and effected by a laser beam with a wavelength corresponding to the spectrum of absorption of the photosensitizer at a power density of 1-10 W / cm 2 .
The preparation containing the photosensitizer is used in the mixture with a penetrant.
When a skin area of the skin affected by the tumor is applied to the surface, a selective accumulation of the photosensitizer in the tumor cells takes place before the laser beam of the photosensitizing drug acts on it. The subsequent exposure to a laser beam with a wavelength corresponding to the photosensitizer absorption spectrum leads to a photochemical reaction with the release of singlet oxygen and the destruction of tumor cells, with laser radiation affecting only the tumor cells without affecting healthy skin tissues.
The content of the photosensitizer in the preparation of the preparation, which is applied to the surface of the affected area of the skin, is 0.07 - 2.0%, allows to create the necessary concentration of the photosensitizer in tumor cells, depending on the nature of the tumor.
Removal of non-absorbed residues of the photosensitizing preparation excludes thermal damage to the surface epithelium when exposed to a laser beam.
The effect of a laser beam at a power density of 1-10 W / cm 2 ensures an intensive photochemical reaction with the release of singlet oxygen without thermal impact on the tumor and healthy skin tissues.
Exposure to a laser beam at a power density of less than 1 W / cm 2 does not result in a photochemical reaction and release of singlet oxygen that destroys tumor cells.
With a power density of 10 W / cm 2, thermal damage to the skin is possible even with a short-term exposure to a laser beam.
Thus, the interaction of the photosensitizer and laser radiation provides selective destruction of tumor cells without thermal impact on the tumor and healthy skin tissues, which increases the efficiency and shortens the treatment time.
The use of a photosensitizing preparation in a mixture with a penetrant ensures the acceleration and intensification of the absorption of the photosensitizer by the skin, as well as its penetration to the required depth.
The method of treatment of lymphomas of the skin is carried out as follows
Before exposure to a laser beam, a preparation prepared in the form of an ointment containing 0.07 - 2.0% of a photosensitizer is applied to the surface of the skin area corresponding to the lymphoma and rubbed with circular movements of the fingers. In each specific case, the content of the photosensitizer is determined depending on the nature of the tumor and the necessary concentration of the photosensitizer in the tumor cells. As a photosensitizer, dimegin, derivatives of hematoporphyrin or chlorin E6 are used. To accelerate and enhance the absorption of the photosensitizer by the skin, and penetrate it to the required depth, use its mixture with a penetrant, for example, in a ratio of 1: 1. As a penetrant, dimethylsulfoxide is used. After exposure for 20 to 30 minutes, the residue of the ointment that has not been absorbed into the skin is removed with warm water to avoid thermal damage to the surface epithelium when exposed to a laser beam. Irradiation of the affected area of the skin is carried out by a 511 and 578 nm copper vapor laser corresponding to the absorption spectrum of said photosensitizer at a radiation power density of 1-10 W / cm 2 for 20 minutes. In each specific case, the power density value is determined depending on the nature of the tumor. After the inflammation subsides, a perfectly acceptable scar remains on the site of the lymphoma. If necessary, after the evaluation of the result, the described treatment session can be repeated.
The suitability of the proposed method for the treatment of skin lymphoma is confirmed by the following examples.
Patient G., 72 years old and patient I., 68 years old. The diagnosis is skin lymphoma. Each patient received three treatment sessions using a hematoporphyrin derivative as a photosensitizer in the form of a 2.0% ointment in a mixture with dimethylsulfoxide at a ratio of 1: 1 and when exposed to a 511 and 578 nm copper vapor laser beam at a radiation power density 2 W / cm 2 for 20 minutes. The time of operation of the ointment on the surface of the affected area of the skin was 20 - 30 minutes. After these three sessions, the patients had complete regression of the tumor.
CLAIM
1. A method for treating skin lymphomas by a laser beam, characterized in that a preparation containing 0.07 to 2.0% of a photosensitizer is applied to the surface of the tumor area of the skin before exposure to the laser beam, maintaining it for at least 15 minutes, and then removing Non-absorbed in the skin remnants of the drug and effected by a laser beam with a wavelength corresponding to the absorption spectrum of the photosensitizer, with a pay power of 1-10 W / cm 2 .
2. A method according to claim 1, characterized in that the preparation containing the photosensitizer is used in a mixture with a penetrant.
print version
Date of publication 01.04.2007гг
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