光动力治疗在口腔肿瘤领域中的应用

doi:10.13701/j.cnki.kqyxyj.2026.08.003

摘要/Abstract

摘要： 光动力治疗(photodynamic therapy,PDT)作为一种新兴的微创治疗手段,在口腔潜在疾患(oral potential malignant disorders,OPMDs)及早期口腔癌的治疗中展现出了显著潜力。光敏剂激活后在组织中产生活性氧,选择性诱导异常细胞凋亡坏死。与传统手术治疗相比,PDT具有微创、不良反应小、组织选择性高、瘢痕形成少、保留口腔功能等优点。PDT在OPMDs的治疗中已被广泛应用。目前研究热点已转向口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)领域。尤其是近年来新兴的PDT与免疫治疗、靶向治疗及纳米技术等疗法的联合策略,展现出巨大的潜力。本综述将从PDT治疗的原理、机制及近年在OPMDs及OSCC患者中的应用现状进行系统性阐述。

关键词: 光动力治疗, 口腔潜在恶性疾患, 口腔鳞状细胞癌

Abstract: Photodynamic therapy (PDT), an emerging minimally invasive treatment, has shown significant potential in the treatment of oral precancerous lesions (OPMDs) and early oral cancer. Photosensitizers produce reactive oxygen species in tissues after activation, selectively inducing abnormal cell apoptosis and necrosis. Compared with traditional surgical resection, PDT has the advantages of minimally invasive, less side effects, high tissue selectivity, reducing scar formation, and preserving oral function. PDT has been well applied in the treatment of OPMDs. The current research focus has shifted to the field of oral squamous cell carcinoma (OSCC). In particular, the emerging combination strategies of PDT and emerging therapies such as immunotherapy, targeted therapy, and nanotechnology in recent years have shown great therapeutic potential. This review systematically elaborates the principle, mechanism, and application status of PDT in OPMDs and OSCC patients in recent years.

Key words: photodynamic therapy, oral potential malignant disorders, oral squamous cell carcinoma

饶淇升, 张国权. 光动力治疗在口腔肿瘤领域中的应用[J]. 口腔医学研究, 2026, 42(8): 651-655.

RAO Qisheng, ZHANG Guoquan. Application of Photodynamic Therapy in Field of Oral Tumor[J]. Journal of Oral Science Research, 2026, 42(8): 651-655.

参考文献

[1] Swanton C, Bernard E, Abbosh C, et al. Embracing cancer complexity: Hallmarks of systemic disease [J]. Cell, 2024, 187(7):1589-1616.
[2] Sobhani N, Samadani AA. Implications of photodynamic cancer therapy: an overview of PDT mechanisms basically and practically [J]. J Egypt Natl Canc Inst, 2021, 33(1):34.
[3] Tan YQ, Li ZT, Zhou G. Developmental synergism in the management of oral potentially malignant disorders [J]. Photodiagnosis Photodyn Ther, 2023, 42:103563.
[4] Gu X, Wang L, Coates PJ, et al. Evidence for etiologic field changes in tongue distant from tumor in patients with squamous cell carcinoma of the oral tongue [J]. J Pathol, 2023, 259(1):93-102.
[5] de Pauli Paglioni M, Migliorati CA, Schausltz Pereira Faustino I, et al. Laser excision of oral leukoplakia: Does it affect recurrence and malignant transformation? A systematic review and meta-analysis [J]. Oral Oncol, 2020, 109:104850.
[6] Khorsandi K, Hosseinzadeh R, Esfahani H, et al. Accelerating skin regeneration and wound healing by controlled ROS from photodynamic treatment [J]. Inflamm Regen, 2022, 42(1):40.
[7] Alzeibak R, Mishchenko TA, Shilyagina NY, et al. Targeting immunogenic cancer cell death by photodynamic therapy: past, present and future [J]. J Immunother Cancer, 2021, 9(1):e001926.
[8] Alabi RO, Elmusrati M, Leivo I, et al. Artificial intelligence-driven radiomics in head and neck cancer: Current status and future prospects [J]. Int J Med Inform, 2024, 188:105464.
[9] Merlin JPJ, Crous A, Abrahamse H. Combining photodynamic therapy and targeted drug delivery systems: Enhancing mitochondrial toxicity for improved cancer outcomes [J]. Int J Mol Sci, 2024, 25(19):10796.
[10] Liu B, Zheng Q, Shi X, et al. Construction and synergistic anti-tumor study of a tumor microenvironment-based multifunctional nano-drug delivery system [J]. J Photochem Photobiol B, 2024, 258:112977.
[11] Mosaddad SA, Namanloo RA, Aghili SS, et al. Photodynamic therapy in oral cancer: a review of clinical studies [J]. Med Oncol, 2023, 40(3):91.
[12] Lv Y, Pu L, Ran B, Xiang B. Targeting tumor angiogenesis and metabolism with photodynamic nanomedicine [J]. Front Cell Dev Biol, 2025, 13:1558393.
[13] Yang D, Lei S, Pan K, et al. Application of photodynamic therapy in immune-related diseases [J]. Photodiagnosis Photodyn Ther, 2021, 34:102318.
[14] Jung E, Lee J, Lee Y, et al. Tumor-targeting H₂O₂-responsive photosensitizing nanoparticles with antiangiogenic and immunogenic activities for maximizing anticancer efficacy of phototherapy [J]. ACS Appl Bio Mater, 2021, 4(5):4450-4461.
[15] Aggarwal I, Puyana C, Chandan N, et al. Field cancerization therapies for the management of actinic keratosis: An updated review [J]. Am J Clin Dermatol, 2024, 25(3):391-405.
[16] Galluzzi L, Vitale I, Warren S, et al. Consensus guidelines for the definition, detection and interpretation of immunogenic cell death [J]. J Immunother Cancer, 2020, 8(1):e000337.
[17] Zhang W, Chen S, Bai Z, et al. Photodynamic therapy for oral squamous cell carcinoma: current status, challenges, and prospects [J]. Int J Nanomedicine, 2024, 19:10699-10710.
[18] Pihl C, Lerche CM, Andersen F, et al. Improving the efficacy of photodynamic therapy for actinic keratosis: A comprehensive review of pharmacological pretreatment strategies [J]. Photodiagnosis Photodyn Ther, 2023, 43:103703.
[19] Moloudi K, Sarbadhikary P, Abrahamse H, et al. Understanding the photodynamic therapy induced bystander and abscopal effects: A review [J]. Antioxidants (Basel), 2023, 12(7):1434.
[20] Cramer GM, Moon EK, Cengel KA, et al. Photodynamic therapy and immune checkpoint blockade [J]. Photochem Photobiol, 2020, 96(5):954-961.
[21] Surendran S, Aboelkheir U, Tu AA, et al. T-cell infiltration and immune checkpoint expression increase in oral cavity premalignant and malignant disorders [J]. Biomedicines, 2022, 10(8):1840.
[22] Greeshma LR, Joseph AP, Sivakumar TT, et al. Correlation of PD-1 and PD-L1 expression in oral leukoplakia and oral squamous cell carcinoma: an immunohistochemical study [J]. Sci Rep, 2023, 13(1):21698.
[23] Ali A, Molska GR, Yeo H, et al. Immune microenvironment in oral potentially malignant disorders and oral cancer: A narrative review [J]. Int J Mol Sci, 2025, 26(14):6650.
[24] Binnal A, Tadakamadla J, Rajesh G, et al. Photodynamic therapy for oral potentially malignant disorders: A systematic review and meta-analysis [J]. Photodiagnosis Photodyn Ther, 2022, 37:102713.
[25] Zhang R, Gao T, Wang D. Photodynamic therapy (PDT) for oral leukoplakia: a systematic review and meta-analysis of single-arm studies examining efficacy and subgroup analyses [J]. BMC Oral Health, 2023, 23(1):568.
[26] Liu D, Zhao S, Li J, et al. The application of physical pretreatment in photodynamic therapy for skin diseases [J]. Lasers Med Sci, 2021, 36(7):1369-1377.
[27] Liu S, Gao G, Jiang Z, et al. The efficacy of different pretreatments combined with photodynamic therapy for actinic keratosis: Systematic review and network meta-analysis [J]. Photodermatol Photoimmunol Photomed, 2023, 39(4):410-413.
[28] Shen SC, Lee WR, Fang YP, et al. In vitro percutaneous absorption and in vivo protoporphyrin Ⅸ accumulation in skin and tumors after topical 5-aminolevulinic acid application with enhancement using an erbium:YAG laser [J]. J Pharm Sci, 2006, 95(4):929-938.
[29] do Amaral SR, Amantino CF, De Annunzio SR, et al. Advanced methylene blue-nanoemulsions for in vitro photodynamic therapy on oral and cervical human carcinoma [J]. Lasers Med Sci, 2022, 37(9):3443-3450.
[30] Kujan O, van Schaijik B, Farah CS. Immune checkpoint inhibitors in oral cavity squamous cell carcinoma and oral potentially malignant disorders: a systematic review [J]. Cancers (Basel), 2020, 12(7):1937.
[31] Gurung P, Lim J, Shrestha R, et al. Chlorin e6-associated photodynamic therapy enhances abscopal antitumor effects via inhibition of PD-1/PD-L1 immune checkpoint [J]. Sci Rep, 2023, 13(1):4647.
[32] Kaneko K, Acharya CR, Nagata H, et al. Combination of a novel heat shock protein 90-targeted photodynamic therapy with PD-1/PD-L1 blockade induces potent systemic antitumor efficacy and abscopal effect against breast cancers [J]. J Immunother Cancer, 2022, 10(9):e004793.
[33] Shi E, Shan T, Wang H, et al. A bacterial nanomedicine combines photodynamic-immunotherapy and chemotherapy for enhanced treatment of oral squamous cell carcinoma [J]. Small, 2023, 19(52):e2304014.
[34] Wang W, Lau R, Yu D, et al. PD1 blockade reverses the suppression of melanoma antigen-specific CTL by CD4⁺ CD25^Hi regulatory T cells [J]. Int Immunol, 2009, 21(9):1065-1077.
[35] Zhang Y, Liu M, Xue S, et al. Boosting hydroxyl radical generation with nitrogen vacancy-modified carbon nitride for triggering dual damage of cancer nucleus dna-mitochondria against hypoxic tumors [J]. Int J Nanomedicine, 2025, 20:8765-8781.
[36] Chen L, Yin Q, Zhang H, et al. Protecting against postsurgery oral cancer recurrence with an implantable hydrogel vaccine for in situ photoimmunotherapy [J]. Adv Sci (Weinh), 2024, 11(46):e2309053.
[37] Li X, Zhang Y, Wu X, et al. In situ antigen-capturing nanochaperone toward personalized nanovaccine for cancer immunotherapy [J]. Small, 2022, 18(32):e2203100.
[38] Ashrafizadeh M, Farhood B, Eleojo Musa A, et al. Abscopal effect in radioimmunotherapy [J]. Int Immunopharmacol, 2020, 85:106663.
[39] Chow A, Perica K, Klebanoff CA, et al. Clinical implications of T cell exhaustion for cancer immunotherapy [J]. Nat Rev Clin Oncol, 2022, 19(12):775-790.