Kankere ea Letlalo le UVB Phototherapy

Kotsi ea ho tšoaroa ke mofetše oa letlalo ka UVB phototherapy ke efe?

Ho fapana le mahlaseli a mahlaseli a kotsi a tsoang khanyeng ea tlhaho ea letsatsi le mabone a ho chesoa ha litlolo, lilemo tse mashome tse sebelisoang ho dermatology li bontšitse hore UVB/UVB-Narrowband phototherapy (eo UVA e sa kenyelletsoeng haholo) ha se kotsi e kholo ea kankere ea letlalo;
ho akarelletsa le basal cell carcinoma (BCC), squamous cell carcinoma (SCC) le cutaneous malignant melanoma (CMM).

Ho tšehetsa polelo ena, ka kopo nahana
lintlha tse latelang tsa thuto, le puisano e latelang:

Boithuto ba retrospective cohort e phatlalalitsoeng ka Tšitoe 2023 e bitsitsoeng
Ketsahalo le boemo ba mofetše oa letlalo ho bakuli ba latelang ultraviolet phototherapy ntle le psoralen ba fihletse qeto ena:

 

 

"Ka kakaretso, bakuli ba 3506 ba phekoloang ka Broadband-ultraviolet-B, narrowband-UVB le / kapa UVAB e kopantsoeng ba ile ba hlahlojoa ka kakaretso ea lilemo tse 7.3 ba fihletse hore ha ho kotsi e eketsehileng ea kankere ea melanoma le kankere ea keratinocyte e fumanoeng ka phototherapy"

Boithuto bo bocha bo khahlisang bo phatlalalitsoeng ka Mmesa 2023 bo bonts'itse "Batho ba nang le vitiligo ba na le kotsi e tlase haholo ea ho tšoaroa ke kankere ea letlalo ea melanoma le eo e seng melanoma ha ba bapisoa le baahi ka kakaretso."
E boetse e boletse joalo "Ka lebaka la matšoenyeho a hore liphekolo tse ling tsa vitiligo, joalo ka phototherapy ea nako e telele, li ka eketsa kotsi ea mofets'e oa letlalo, phokotso e bonts'itsoeng ea ts'oaetso ea mofets'e oa letlalo e lokela ho khothatsa batho ba nang le vitiligo le lingaka tse laolang boemo bona."

A thuto e ncha e phatlalalitsoeng ka Phato 2022 ho tsoa Vancouver (Ketsahalo ea kankere ea letlalo ho bakuli ba nang le eczema ba phekoloang ka ultraviolet phototherapy) e etsa qeto ea hore:

 

"Ka kakaretso, ntle le ho bakuli ba nang le nalane ea ho noa kalafo ea immunosuppressive †, ha hoa ka ha e-ba le kotsi e eketsehileng ea melanoma, squamous cell carcinoma, kapa basal cell carcinoma ho bakuli ba fumanang ultraviolet phototherapy, ho kenyelletsa le narrowband UVB, Broadband UVB, le UVA hammoho le Broadband. UVB, e tšehetsang sena e le kalafo e seng ea kankere ho bakuli ba nang le atopic eczema. ”

“Litlhahlobo tse entsoeng liphuputsong tse entsoeng ka UVB, ka li-narrowband le li-broadband, ha li bontše kotsi e eketsehileng ea ho tšoaroa ke kankere ea letlalo e sa melang kapa melanoma.”

Ho bala thuto e felletseng, latela sehokelo sena:

Kalafo bakeng sa psoriasis le kotsi ea ho ba malignancy.

Patel RV1, Clark LN, Lebwohl M, Weinberg JM.

"Phuputsong ena e kholo, ka ho latela lilemo tse 22 ho tloha kalafo ea pele le NB-UVB, ha rea ​​ka ra fumana kamano e tiileng lipakeng tsa kalafo ea NB-UVB le BCC, SCC kapa mofetše oa letlalo oa melanoma." 

Ho bala thuto e felletseng, latela sehokelo sena:
Ketsahalo ea kankere ea letlalo ho bakuli ba 3867 ba phekoloang ka Narrow-Band UVB Phototherapy
Utloa RMKerr ACRahim KFFerguson JDawe RS.

"Ha ho kotsi e eketsehileng ea kankere ea letlalo e bontšitsoeng lithutong tse 'nè tse hlahlobang ka ho khetheha kotsi e ka bang teng ea kankere ea NB-UVB."

Ho bala thuto e felletseng, latela sehokelo sena:
Likotsi tsa kankere tsa psoralen UV-A therapy le phekolo ea UV-B e moqotetsane ka nako e telele ea plaque psoriasis: tlhahlobo e hlophisitsoeng ea lingoliloeng.

Archier E1, Devaux S, Castela E, Gallini A, Aubin F, Le Maître M, Aractingi S, Bachelez H, Cribier B, Joly P, Jullien D, Misery L, Paul C, Ortonne JP, Richard MA.

"Ho ne ho se na phapang e kholo ea lipalo pakeng tsa nbUVB le lihlopha tsa taolo. Kahoo, nbUVB phototherapy e sebelisang mabone a TL-01 e bonahala e le mokhoa o sireletsehileng oa phekolo bakeng sa bakuli ba nang le phototypes ea letlalo III-V.

Ho bala thuto e felletseng, latela sehokelo sena:
Ha ho na bopaki ba ho eketseha ha kotsi ea mofetše oa letlalo ho Makorea a nang le li-phototypes tsa letlalo III-V tse tšoaroang ka mokhoa o moqotetsane oa UVB phototherapy.

Jo SJ1, Kwon HH, Choi MR, Youn JI.

“Dr. Lebwohl o rialo. "Bonyane ho fihlela joale, ho bonahala eka lesela le moqotetsane la UVB ha le kenye letsoho mofetšeng oa letlalo. Leha ho le joalo, ho bakuli ba tšoeroeng ke mofetše, re hlokolosi mabapi le tšebeliso ea phototherapy. ”

Ho bala thuto e felletseng, latela sehokelo sena:
Mekhoa e tloaelehileng ea phekolo ea psoriasis
le tsusumetso e mpe menyetla ea bakuli ba ho ba le mofetše oa letlalo Dermatology Times May-2017

"Ka hona, thuto ea hona joale ha e fane ka bopaki ba kotsi e eketsehileng ea kankere ea letlalo bakeng sa bakuli ba tšoaroang ka phototherapy ea Broadband kapa narrowband UVB" 


Ho bala thuto e felletseng, latela sehokelo sena:
Ha ho na bopaki ba ho eketseha ha kotsi ea mofetše oa letlalo ho bakuli ba psoriasis ba tšoaroang ka Broadband kapa narrowband UVB phototherapy: thuto ea pele ea morao-rao.

Weischer M1, Blum A, Eberhard F, Röcken M, Berneburg M.

"(UVB-Narrowband) Phototherapy e bolokehile ebile e bonolo ho e etsa. Le hoja mathata a ka kenyelletsa ho chesoa ke letsatsi, ha re bone kankere ea letlalo, melanoma kapa non-melanoma. Ho ka etsahala hore ebe lefu la vitiligo le sireletsa khahlanong le melanoma.” 

Mehopolo e mecha, liphekolo tsa vitiligo - Pearl Grimes - Dermatology Times Aug-2016

Ho sa tsotellehe ho ameha ka matla a mahlaseli a kotsi a kankere, liphuputso tse ngata ha li e-s'o fumane kotsi e eketsehileng ea kankere ea letlalo e se nang melanoma kapa melanoma ho bakuli ba phekoloang ka ultraviolet B (broadband le narrowband) le phototherapy ea ultraviolet A1."

Ho bala thuto e felletseng, latela sehokelo sena:
Lehlakore le lefifi la leseli: Phototherapy litlamorao tse mpe.

Valejo Coelho MM1, Apetato M2.

Puisano

Mahlaseli a Ultraviolet (UVR) a tsoang letsatsing la tlhaho
“e nkuoa e le eona sesosa se ka sehloohong
ho kenella ha mofetše oa letlalo”

UVR e arotsoe ka likarolo tse latelang:

UVA
320-400nm
Maqhubu a ho fifala ha letlalo

UVB
280-320nm
Maqhubu a tukang

UVC
100-280nm
E tlhotliloeng ka sepakapaka sa lefatše

UVB UVA
Kahoo, molemong oa puisano ena, UVR=UVA+UVB.

Bophahamo bo bong le bo bong bo fapaneng ba khanya bo hlahisa mefuta e fapaneng ea litlamorao tse fapaneng tsa tlhaho letlalong la motho. Maqhubu a malelele a UVA a phunyeletsa ka har'a letlalo, athe UVB e phunyeletsa feela ho epidermis.

Ho na le mefuta e meraro e meholo ea mofets'e oa letlalo:

BCC

basal cell carcinoma

SCC

squamous cell carcinoma

CMM

letlalo le kotsi la melanoma

BCC le SCC li hlophisitsoe hammoho e le li-non-melanoma skin cancers (NMSC), 'me li itšetlehile ka tekanyetso ea UVB ea bophelo bohle. Libaka tsa letlalo tse fumaneng tekanyo e kholo ea bophelo ba UVR ke tsona tse hlaselehang habonolo, joalo ka hlooho, molala, sefuba le matsoho a pele. NMSC e ka phekoleha ha bonolo ha e fumanwa kapele.
Kankere ea letlalo le UVB Phototherapy
Le hoja UVB e ikarabella bakeng sa ho chesa letlalo (erythema) le NMSC, ke ntho e makatsang hape le waveband e etsang Vitamin D letlalong 'me e sebetsa ka ho fetisisa bakeng sa phekolo ea mefuta e mengata ea mafu a letlalo.

Ho fokotsa erythema le NMSC ha e ntse e fana ka kalafo e sebetsang ea lefu la letlalo, UVB-Narrowband (311nm peak, /01) e ile ea ntlafatsoa ke Philips Lighting lilemong tsa bo-1980 'me hona joale e laola phototherapy ea bongaka lefatšeng ka bophara. Ho fumana lintlha tse ling bona: Ho utloisisa Narrowband UVB Phototherapy.

Melanoma ke kankere ea letlalo e kotsi ka ho fetisisa kaha e ka fetisetsa mofetše likarolong tse ling tsa 'mele. “Ho ka etsahala hore ebe mabaka a kopantsoeng, ho akarelletsa le tikoloho le liphatsa tsa lefutso, a baka melanoma. Leha ho le joalo, lingaka li lumela hore ho pepesetsoa mahlaseli a kotsi a tsoang letsatsing le mabone a chesang le libethe ke sesosa se ka sehloohong sa melanoma.”17

Leseli la UV ha le bake melanoma eohle, haholo-holo e hlahang libakeng tse 'meleng oa hau tse sa fumaneng khanya ea letsatsi. Sena se bontša hore mabaka a mang a ka baka kotsi ea ho tšoaroa ke melanoma. Melanoma e ka bakoa ke UVA le UVB ka bobeli, empa ho na le bopaki ba hore UVA e ka bapala karolo e ka sehloohong.3

Lisosa tse kotsi tsa melanoma li akarelletsa: li- moles ( melanocytic nevi ), mofuta oa letlalo (batho ba letlalo le hloekileng ba kotsing e khōloanyane ho feta ba letlalo le lefifi), le ho chesoa ke letsatsi khafetsa, haholo-holo bongoaneng. “Ho pepesehela khanya ea letsatsi nako le nako ho amahanngoa haholo le nts'etsopele ea melanoma ho feta ho lula u le letsatsing letsatsi le letsatsi.. " 6

Leha ho le joalo ho hlalosoa ke taba ea hore "Melanoma e atile haholo har'a batho ba sebetsang ka tlung ho feta har'a batho ba pepesehelang mahlaseli a kotsi a tikoloho (lihoai, batšoasi ba litlhapi, joalo-joalo).

Bongata ba lingoliloeng tsa saense tsa mofetše oa letlalo bo amana le litlamorao tsa khanya ea letsatsi ea tlhaho (UVR, e nang le boholo ba UVA, ka liperesente tse fokotsehang tsa UVB ha latitude e ntse e eketseha),

Empa ho thoe'ng ha ho sebelisoa UVB feela (e sa kenyelelitsoe UVA), joalo ka kalafong ea phototherapy ea UVB / UVB-Narrowband ea bongaka?

Leha taba ea hore sekhahla sa ts'ebetso sa NMSC se batla se le maemong a UVB, lithuto tse kaholimo li bonts'a hore UVB/UVB-Narrowband phototherapy hase sesosa se seholo sa kotsi bakeng sa kankere ea letlalo; ho akarelletsa le basal cell carcinoma (BCC), squamous cell carcinoma (SCC) le cutaneous malignant melanoma (CMM).

Ho ba sieo ha UVA e ka bang kotsi ho ka ba le karolo, 'me "Ka kakaretso, ho na le bopaki bo bong ba hore vithamine D e ka bapala karolo ea kankere ea letlalo ea nonmelanoma (NMSC) le thibelo ea melanoma, le hoja ho fihlela joale ha ho na bopaki bo tobileng bo bontšang phello ea tšireletso." 14,15 "Liphuputso tse 'maloa li bontšitse hore vithamine D e phetha karolo ea tšireletso ho mefuta e sa tšoaneng ea mafu a ka hare. Mabapi le mofetše oa letlalo, liphuputso tsa epidemiologic le laboratori li bontša hore vithamine D le metabolites ea eona li ka ba le phello e tšoanang ea tšireletso.. " 13

Ho sebetsana le matšoenyeho a NMSC e hlahisitsoeng ke UVB, hobane e itšetlehile ka tekanyo ea bophelo bohle, haholo-holo bakeng sa batho ba letlalo le leeme, hoa utloahala ho qhelela ka thoko libakeng tsa letlalo tse sa hlokeng kalafo le ho ba le UVR e ngata bophelong ba mokuli. le ho sireletsa libaka tseo ho UVR e eketsehileng mahlaseling a tlhaho a letsatsi. Ba nang le nalane le / kapa nalane ea lelapa la mofets'e oa letlalo ba lokela ho buisana le ngaka ea bona pele ba nka UV phototherapy. Hape ba lokela ho “hlahlobisisa letlalo” bonyane selemo le selemo ho bona kankere ea letlalo; joalo ka ha mang kapa mang a pepesehetse khanya ea ultraviolet, e ka ba ho tsoa kalafong ea bongaka ea UV ea bongaka, lisebelisoa tsa ho tantša ka litlolo, kapa khanya ea letsatsi ea tlhaho.

Ho feta moo, UVR e tsoang khanyeng ea letsatsi ea tlhaho hangata e amoheloa ho tsoa holimo ho motho (mohlala, letsatsi le chabang holimo phatleng, litsebeng le mahetleng). mmele o felletseng Phototherapy ea UVB e batla e fanoa ka lehlakoreng le leng (hangata bakuli ba emela kalafo ho tsoa sesebelisoa se theohileng), ka hona, ho na le phokotso ea ho pepeseha ha geometri libakeng tse kotsing ka ho fetesisa. Mokhahlelo oa pele oa "ho hloekisa" oa UVB hangata o kenyelletsa litekanyetso tse kholoanyane tsa UVB phototherapy ka likhoeli tse 'maloa, tse lateloang ke liphekolo tsa nako e telele tsa "tlhokomelo" ka litekanyetso tse fokotsehileng le khafetsa.

Letsatsi le felletseng la Mmele
Sesebelisoa sa 'Mele o Tletseng
UVB phototherapy ha e hloke hore mokuli a chesoe ke letsatsi, 'me litekanyetso tsa UVB tse ka tlaase ho tekanyo li sebetsa hantle bakeng sa tlhokomelo ea nako e telele "Na Liuniti tsa Lehae tsa Narrow-band Ultraviolet B ke Khetho e ka khonehang bakeng sa Phekolo e Tsoelang Pele kapa ea Tlhokomelo ea Mafu a Letlalo a Phokotso?” ,18 le ho boloka vithamine D e lekaneng. 09,11,12

Lisebelisoa tsohle tsa SolRx UVB-Narrowband ke Health Canada e lumellanang le "Vitamin-D Deficiency" e le "pontšo ea tšebeliso", ho bolelang hore li ikemiselitse ho sireletseha le ho sebetsa hantle, 'me kahoo li ka rekisoa ka molao bakeng sa morero oo Canada. 10

Mabapi le Home phototherapy, mokhoa oo ka tlhaho o tenang oa ho nka liphekolo le tlhaho ea motho e tataisa mokuli hore a nke feela UVB e hlokahalang ho boloka letlalo le hlakile kapa le batla le hlakile. Bakuli ba phototherapy ba lapeng hangata e ba litsebi tsa hore na UVB e lokela ho nka bokae le hore na, ka litekanyetso tse nyane, khafetsa, tse ratoang ke ba bangata.

Phototherapy ea lapeng e boetse e etsa hore ho se be bonolo hore liphekolo li fosoe 'me liphekolo tse latelang li hlahise ho chesoa ke letsatsi ho sa batleheng. Ho tseba, "Ultraviolet B phototherapy lapeng e sebetsa ka mokhoa o ts'oanang bakeng sa ho alafa psoriasis joalo ka ultraviolet B phototherapy sebakeng sa bakuli ba kantle mme e fana ka maikutlo a hore ha ho na likotsi tse ling tsa ts'ireletso maemong a thibelang mahlaseli a sa boleloang. Ho feta moo, phekolo ea lapeng e baka moroalo o fokolang, e ananeloa hamolemonyana, ’me e fana ka ntlafatso e tšoanang ea boleng ba bophelo. Bakuli ba bangata ba boletse hore ba ka khetha phekolo ea nakong e tlang ea ultraviolet B lapeng ho feta phototherapy sebakeng sa bakuli ba ka ntle. 16

Solarc Systems e amohela litlhahiso leha e le life tsa ho ntlafatsa sengoloa sena sa litaba tsa sechaba.

HLOKOMELA

Ho bohlokoa hore UVB le UVB-Narrowband phototherapy e se ke ea ferekanngoa le PUVA (psoralen + UVA light), kaha "karolo ea phekolo ea PUVA ho kankere ea letlalo ho batho ba nang le psoriasis e bontšitsoe ka ho hlaka" [Likotsi tsa carcinogenic tsa PUVA le nbUVB ho chronic plaque psoriasis_ tlhahlobo e hlophisitsoeng ea lingoliloeng 2012] PUVA hangata e lekanyelitsoe ho liphekolo tse 200 ho isa ho tse 300, mme feela bakeng sa linyeoe tse tebileng tse hlolehileng UVB kapa UVB-Narrowband phototherapy.   

References:

1 Brenner, Michaela, le Vincent J. Ho utloa. “Karolo ea Tšireletso ea Melanin Khahlanong le Tšenyo ea UV Letlalo la Motho. " Photochemistry le Photobiology, matla. 84, no. 3, 2007, maqephe 539-549., doi: 10.1111 / j.1751-1097.2007.00226.x.

2 "Setsi sa Kankere ea Letlalo / Melanoma: Matšoao, Liphekolo, Matšoao, Mefuta, Lisosa le Liteko. WebMD

3 Setlow, RB, le tse ling. “Wavelengths e Atlehang ho Induction of Malignant Melanoma.Proceedings of National Academy of Sciences, vol. 90, no. 14, 1993, maqephe 6666-6670., doi: 10.1073 / pnas.90.14.6666.

4 Berneburg, Mark, le Lena Krieger. "Faculty of 1000 Evaluation for Melanoma Induction ka Ultraviolet A empa E seng Ultraviolet B Radiation e Hloka Melanin Pigment." F1000 - Tlhahlobo ea Lithaka ea Kamor'a Phatlalatso ea Lingoliloeng tsa Biomedical, 2012, doi:10.3410/f.717952967.793458514.

5 Brenner, Michaela, le Vincent J. Ho utloa. “Karolo ea Tšireletso ea Melanin Khahlanong le Tšenyo ea UV Letlalo la Motho. " Photochemistry le Photobiology, matla. 84, no. 3, 2007, maqephe 539-549., doi: 10.1111 / j.1751-1097.2007.00226.x.

6 Rhodes, A.Lintlha tsa Kotsi ea Melanoma. " AIM ho Melanoma, Fitzpatrick's Dermatology in General Medicine

7 Juzeniene, Asta, le Johan Moan. “Liphello tse Molemo tsa Mahlaseli a UV Ntle le ka Tlhahiso ea Vithamine D. " Dermato-Endocrinology, matla. 4, no. 2, 2012, maqephe 109-117., doi: 10.4161 / derm.20013.

8 Maverakis, Emanual, et al. “Leseli, Ho kenyelletsa le Ultraviolet. " Setsi sa Sechaba sa Bophelo, May 2010, doi:10.1016/j.jaut.2009.11.011.

9 United States, Congress, Lenaneo la Naha la Toxicology. “Broad-SpectrumUltraviolet (UV) RadiationandUVA, le UVB, le UVC.Mahlaseli a Broad-SpectrumUltraviolet (UV) le UVA, le UVB, le UVC, Koporasi ea Moralo le Tsamaiso ea Theknoloji, 2000.

10 “Boitsebiso ba Taolo.” Litlhaloso tsa likarolo tsa Solarc Systems Inc.,

11 Bogh, Mkb, le ba bang. “Narrowband Ultraviolet B Makhetlo a Mararo ka Beke e Atlehile ho Phekola Khaello ea Vithamine D ho feta 1600IU Oral Vithamine D3 ka Letsatsi: Teko ea Meriana e Randomized.. " Koranta ea Brithani ea Dermatology, matla. 167, no. 3, 2012, maqephe 625-630., doi: 10.1111 / j.1365-2133.2012.11069.x.

12 Ala-Houhala, Mj, et al. “Papiso ea Narrowband Ultraviolet B Exposure le Oral Vithamine D Substitution ka Serum 25-Hydroxyvitamin D Concentration.Koranta ea Brithani ea Dermatology, matla. 167, no. 1, 2012, maqephe 160–164., doi:10.1111/j.1365-2133.2012.10990.x

13 Tang, Jean Y., le al. “Vithamine D ho Cutaneous Carcinogenesis: Karolo ea I.Setsi sa Sechaba sa Bophelo, Nov. 2012, doi:10.1016/j.jaad.2012.05.044.

14 Tang, Jean Y., le al. “Vithamine D ho Cutaneous Carcinogenesis: Karolo ea II.Setsi sa Sechaba sa Bophelo, Nov. 2012, doi:10.1016/j.jaad.2012.05.044.

15 Navarrete-Dechent, Cristián, et al. “Protein e Tlamang ea Vithamine-D le Li-Concentrations tsa mahala tsa 25-Hydroxyvitamin D ho Bakuli ba nang le Melanoma: Thuto ea Taolo ea Nyeoe."Journal ea American Academy of Dermatology, vol. 77, no. 3, 2017, maqephe 575-577., doi: 10.1016 / j.jaad.2017.03.035.

16 Koek, M. BG, le ba bang. “Lehae khahlano le Mokuli oa Kantle Ultraviolet B Phototherapy bakeng sa Psoriasis e Bonolo ho isa ho E Matla: Teko ea Pragmatic Multicentre Randomized Controlled Non-Inferiority (Thuto ea PLUTO). Bmj, matla. 338, no. may07 2 July 2009, doi:10.1136/bmj.b1542.

17 https://www.mayoclinic.org/diseases-conditions/melanoma/symptoms-causes/syc-20374884

18 Na Liuniti tsa Lehae tsa Narrow-band Ultraviolet B ke Khetho e ka khonehang bakeng sa Phekolo e Tsoelang Pele kapa ea Tlhokomelo ea Mafu a Letlalo a Phokotso?"