Treatment System

Abstract

Provided is a therapy method and a therapy system whereby a therapy can be performed while confirming the degree of the destruction of tumor cells which may be caused by the irradiation with light and the effect of the therapy can be improved.　A therapy system (10) for irradiating a light-sensitive substance accumulated in a tumor cell of breast cancer with excitation light, the therapy system (10) being equipped with an optical device (20) which is provided with an optical fiber (27) that can propagate light between a base end part and a tip end part and which is also provided with, at the tip end part thereof, an irradiation unit (25) that can emit light to the outside and a detection unit (26) that can detect light in the outside, in which the tip end part of the optical device (20) can be inserted into a breast duct (B) through a breast duct opening (Bo).

Description

[Technical field]

[0001] The present invention relates to a method for destroying tumor cells. The cure Related to medical devices. [Background technology]

[0002] In breast cancer treatment, breast-conserving therapy has great advantages in terms of improving the quality of life of patients. However, local recurrence after breast-conserving therapy is currently seen in 10-20% of cases. For this reason, satisfaction with local treatment in breast-conserving therapy is still not high.

[0003] In the localized treatment of cancer, a method using a photoreactive substance to destroy target cells such as tumor cells is known. In particular, a treatment using an antibody-photosensitive substance (hydrophilic phthalocyanine) can specifically destroy only the target cells without destroying non-target cells such as normal cells by irradiating the antibody-photosensitive substance accumulated in the tumor with excitation light (e.g., near-infrared light). For this reason, this treatment is expected to achieve a high therapeutic effect while minimizing side effects. Furthermore, as a therapeutic effect, an immune response is induced via fragments of the destroyed cells, and a therapeutic effect is expected due to the patient's own immune function. If localized treatment using such a photoreactive substance can be applied to breast cancer patients, it is expected that a high therapeutic effect can be obtained while preserving the breast.

[0004] Patent Document 1 describes a device that can be inserted into the milk duct to cauterize the lesion. This device destroys not only the lesion but also normal cells, so it places a heavy burden on the living body. [Prior art documents] [Patent documents]

[0005] [Patent Document 1] U.S. Patent No. 8,323,181 Summary of the Invention [Problem to be solved by the invention]

[0006] In order to obtain a high therapeutic effect of photosensitive substances, it is necessary to reliably irradiate the photosensitive substances accumulated in the tumor with excitation light. However, since the intensity of light rapidly attenuates as the distance of the tissue through which it penetrates increases, it is very difficult to non-invasively irradiate tumors inside the body with light of sufficient intensity from the body surface. Therefore, a means is required to reliably irradiate tumors inside the body with light while minimizing invasiveness. In addition, in order to maximize the therapeutic effect, it is required to be able to measure during treatment whether the reaction of the photosensitive substances accumulated in the tumor due to the excitation light has progressed sufficiently. If the destruction of cancer cells due to the photoreaction can be measured during treatment, it will be possible to optimally set the irradiation time and improve the therapeutic effect.

[0007] The present invention has been made to solve the above-mentioned problems, and is capable of treating tumor cells while checking the degree of destruction of the tumor cells by irradiation with light, thereby improving the therapeutic effect. Ru The present invention aims to provide a medical treatment system. [Means for solving the problem]

[0008] The treatment according to the present invention achieves the above objectives The system is a treatment system that irradiates excitation light to photosensitive substances accumulated in breast cancer tumor cells, and includes an optical device equipped with an optical fiber capable of propagating light between a base end and a tip end, the tip end of which is equipped with an irradiation unit capable of irradiating light to the outside and a detection unit capable of detecting external light, and an analysis device connected to the base end of the optical device and receiving and analyzing light detected by the detection unit, the tip end of the optical device being insertable into a milk duct through a milk duct opening, the analysis device calculates the intensity of the fluorescence received from the detection unit, and when the intensity of the fluorescence becomes equal to or less than a threshold value, outputs a threshold reaching signal indicating that the intensity has become equal to or less than the threshold value. It is characterized by: Effect of the Invention

[0019] The treatment system configured as described above can effectively irradiate the photosensitive substance accumulated in the tumor cells with excitation light by disposing the irradiation unit and detection unit of the optical device in positions close to the tumor cells in the breast duct, and can effectively detect the fluorescence emitted by the photosensitive substance accumulated in the tumor cells. Therefore, the treatment system can treat the tumor cells while checking the degree of destruction of the tumor cells by irradiation with the excitation light by detecting the fluorescence, and can improve the treatment effect.

[0020] The treatment system has an analyzer connected to a proximal end of the optical device for receiving and analyzing the light detected by the detection unit, and the analyzer calculates the intensity of the fluorescence received from the detection unit, and when the intensity of the fluorescence becomes equal to or less than a threshold value, outputs a threshold reaching signal indicating that the intensity of the fluorescence becomes equal to or less than the threshold value. do This allows the treatment system to notify the surgeon that the intensity of the fluorescence is equal to or lower than the threshold value, and to stop irradiating the excitation light.

[0021] The tip of the optical device may have an expansion section that can expand and contract in the radial direction, and the irradiation section and the detection section may be disposed in the expansion section. In this way, the irradiation section and the detection section can be disposed near the inner wall of the milk duct by expanding the expansion section inside the milk duct. This reduces the influence of body fluid in the milk duct that prevents light from reaching the duct, and the photosensitive substance accumulated in the tumor cells can be effectively irradiated with excitation light from the irradiation section, and the fluorescence emitted by the photosensitive substance accumulated in the tumor cells can be effectively detected.

[0022] In the treatment system, the photosensitizer may contain an antibody-photosensitizer bound to an antibody that accumulates in tumor cells, whereby the accumulation of the photosensitizer in tumor cells is improved by the antibody bound to the photosensitizer, and tumor cells can be destroyed more reliably. [Brief description of the drawings]

[0023] [Figure 1] FIG. 1 is a plan view showing a treatment system according to a first embodiment. [Diagram 2] 1 is a schematic diagram showing the internal state of the body when breast cancer is treated by the treatment system according to the first embodiment. FIG. [Diagram 3] 1 is a graph showing the intensity of light displayed on a display device. [Figure 4] FIG. 1 is a schematic diagram showing a state in which breast cancer is being treated by the treatment system according to a first embodiment. [Diagram 5] 10 is a flowchart showing a control flow in a processing unit. [Figure 6] FIG. 11 is a plan view showing a treatment system according to a second embodiment, in which (A) shows a state before the expansion section is expanded, and (B) shows a state after the expansion section is expanded. [Figure 7] FIG. 11 is a schematic diagram showing the internal state of the body when breast cancer is treated by a treatment system according to a second embodiment. [Figure 8] FIG. 11 is a plan view showing a modified example of the treatment system according to the second embodiment, in which (A) shows the state before the expansion section is expanded, and (B) shows the state after the expansion section is expanded. [Figure 9] FIG. 13 is a schematic diagram showing the internal state of the body when breast cancer is treated by a treatment system according to a third embodiment. [Figure 10] FIG. 13 is a schematic diagram showing the internal state of the body when breast cancer is treated by a treatment system according to a fourth embodiment. [Figure 11] 1 is a graph showing the intensity of light displayed on a display device. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0024] Hereinafter, an embodiment of the present invention will be described with reference to the drawings. For convenience of explanation, the dimensions of the drawings may be exaggerated and may differ from the actual dimensions. In this specification and the drawings, components having substantially the same functional configurations are given the same reference numerals to avoid redundant explanation. In this specification, the side of the device that is inserted into a biological lumen is referred to as the "distal side" and the side that is operated is referred to as the "base side".

[0025] First Embodiment

[0026] The treatment system 10 according to the first embodiment is used in photoimmunotherapy, which destroys target cells by irradiating near-infrared rays to a photosensitive substance accumulated on the cell membrane of the target cell. The target cell is a tumor cell such as a cancer cell. In this treatment method, an antibody-photosensitive substance, which is a combination of an antibody that specifically accumulates only on a specific antigen on the surface of the tumor cell and a photosensitive substance that pairs with the antibody, is used as a drug. The antibody is not particularly limited, but examples thereof include panitumumab, trastuzumab, HuJ591, pertuzumab, lapatinib, palbociclib, and olaparib. The photosensitive substance is, for example, but not limited to, hydrophilic phthalocyanine (IR700) that reacts to near-infrared rays with a wavelength of about 700 nm, or hydrophilic phthalocyanine (IR800) that reacts to near-infrared rays with a wavelength of about 789 to 794 nm. When IR700 is exposed to near-infrared rays with a wavelength of about 660 to 740 nm, the ligand of the functional group that ensures water solubility is broken, and a structural change from water solubility to hydrophobicity occurs. This structural change pulls out membrane proteins, opening holes in the cell membrane and allowing water to enter the cell, which can cause the cancer cells to burst and be destroyed. In addition, IR700 is excited by receiving near-infrared rays and emits fluorescence with a wavelength different from the excitation wavelength. For example, when IR700 is excited by receiving near-infrared rays with a wavelength of 689 nm, it emits fluorescence with a wavelength of 700 to 705 nm. IR700 undergoes a structural change while emitting fluorescence due to a photoreaction, and when it destroys tumor cells and fulfills its role as a drug, it no longer emits fluorescence. The treatment system 10 according to this embodiment irradiates near-infrared rays to the antibody-photosensitive substance accumulated in the tumor cells, and detects the change in the fluorescence emitted by the antibody-photosensitive substance, thereby measuring in real time that the tumor cells are destroyed by the photoreaction of the antibody-photosensitive substance. Note that "real time" is not limited to being performed strictly at approximately the same time, but is a broad concept that means that detection of changes in the intensity of the fluorescence emitted by the antibody-photosensitizer is performed in parallel with irradiation of near-infrared light with a slight time difference, or irradiation and detection are repeated at short intervals of a few seconds or less. The time difference may be a time lag caused by communication, calculation, etc., or a set or calculated value. Note that the treatment system 10 does not need to perform measurements in real time as long as it can measure during treatment that tumor cells have been destroyed by the photoreaction of the antibody-photosensitizer.

[0027] As shown in Figures 1 and 2, the treatment system 10 includes an optical device 20 that irradiates and detects light within the milk duct B, a light source device 30 that supplies light to the optical device 20, an analysis device 40 that analyzes the detected light, and a display device 50 that displays the analysis results.

[0028] The light source device 30 has an output section 31 that can output near-infrared light of any wavelength with any intensity (power) or energy, and a reference light output section 32 that outputs the same light as the output section 31 as reference light. The output section 31 is connected to the optical device 20. The reference light output section 32 is connected to the analysis device 40. The light source device 30 outputs, for example, a near-infrared light having a wavelength of 660 to 740 nm and an intensity of, for example, 1 to 50 Jcm. -2 The light is output to the optical device 20 so that light with this energy can be emitted from the optical device 20.

[0029] The optical device 20 includes a shaft portion 21 to be inserted into the milk duct B, an input cable 22 connected to the light source device 30, an output cable 23 connected to the analysis device 40, and an optical circulator 24.

[0030] A base end of the input cable 22 can be connected to the output unit 31 of the light source device 30, and a tip end of the input cable 22 is connected to the optical circulator 24. The input cable 22 has at least one optical fiber that propagates light, and propagates the light received from the output unit 31 to the optical circulator 24.

[0031] A base end of the output cable 23 can be connected to an analysis device 40, and a tip end of the output cable 23 is connected to the optical circulator 24. The output cable 23 has at least one optical fiber that propagates light, and propagates the light received from the optical circulator 24 to the analysis device 40.

[0032] The shaft portion 21 includes at least one optical fiber 27 that propagates light. The base end of the shaft portion 21 is connected to an optical circulator 24. The tip end of the shaft portion 21 includes an irradiation portion 25 that irradiates light to the outside, and a detection portion 26 that detects external light. Each of the shaft portion 21, the input cable 22, and the output cable 23 may be composed of a single fiber or a bundle of multiple fibers.

[0033] The optical circulator 24 propagates the light received from the input cable 22 to the shaft portion 21. Moreover, the optical circulator 24 propagates the light received from the shaft portion 21 to the output cable 23. Note that the optical device 20 does not necessarily have to include the optical circulator 24. For example, the shaft portion 21 may include a plurality of optical fibers 27, and the optical fibers 27 connected to the irradiation portion 25 of the shaft portion 21 may be connected to the input cable 22, and the optical fibers 27 connected to the detection portion 26 of the shaft portion 21 may be connected to the output cable 23.

[0034] The irradiation unit 25 irradiates the light propagated from the base end side to the tip side through the optical fiber 27 to the outside. The irradiation unit 25 may be configured, for example, by a structure in which the cut end of the optical fiber 27 is exposed, a structure in which the surface coating is peeled off, a lens, a diffuser, a mirror, or the like. The irradiation unit 25 is appropriately designed so as to irradiate near-infrared rays in a predetermined direction at a predetermined irradiation angle. The structure of the irradiation unit 25 is not limited as long as it can irradiate light to the outside. In addition, the irradiation direction of the irradiation unit 25 (the direction in which the center of the irradiation angle is located) is not particularly limited. For example, the irradiation direction of the irradiation unit 25 may be the tip direction of the shaft portion 21 or a direction approximately perpendicular to the axis of the shaft portion 21.

[0035] The detection unit 26 receives external light into the optical fiber 27 and detects the light. The light that enters the optical fiber 27 is propagated to the base end side of the optical fiber 27. The detection unit 26 may be configured, for example, by a structure in which the surface coating of the optical fiber 27 is peeled off, a lens, a diffuser, a mirror, or the like. The detection unit 26 may have a structure in common with the irradiation unit 25. That is, the detection unit 26 may be the irradiation unit 25.

[0036] The analysis device 40 is a device that monitors the action of near-infrared light on a tumor C having tumor cells during treatment. The monitoring is performed in real time, but does not have to be performed in real time. The analysis device 40 includes a detection light input unit 41 that receives light detected by the detection unit 26 of the optical device 20, and a reference light input unit 42 that receives reference light from the reference light output unit 32 of the light source device 30. The detection light input unit 41 is connected to the output cable 23 of the optical device 20. The reference light input unit 42 is connected to a reference light cable 33 that is connected to the reference light output unit 32 of the light source device 30.

[0037] The analysis apparatus 40 receives light from the output cable 23 of the optical device 20, analyzes the intensity of the light at each wavelength, and can monitor the destruction of tumor cells in which the antibody-photosensitizer has accumulated.

[0038] The analysis device 40 includes, as physical hardware configurations, a photoelectric conversion unit 43 that converts light into an electrical signal after passing it through a filter that disperses the light into individual wavelengths or selectively extracts only specific wavelengths, a storage unit 44, and a processing unit 45. The storage unit 44 is, for example, a semiconductor memory element such as a random access memory (RAM) or a flash memory, or a hard disk, an optical disk, etc. The storage unit 44 can write or read a fluorescence threshold value T, which will be described later, a program, etc., depending on the processing status.

[0039] The processing unit 45 is, for example, a CPU (Central Processing Unit), an MPU (Micro Processing Unit), or the like. The processing unit 45 can execute a program stored in the storage unit 44, for example, using a RAM as a working area, to perform arithmetic processing. The processing unit 45 monitors a change in the intensity of the fluorescence FL of a wavelength emitted by the antibody-photosensitizer that has received near-infrared light, and when the intensity of the fluorescence FL becomes equal to or less than a threshold value T or less than the threshold value T, as shown in Figs. 1 and 3, notifies the operator via the display device 50. Alternatively, when the intensity of the fluorescence FL becomes equal to or less than a threshold value T or less than the threshold value T, the processing unit 45 may control the light source device 30 via a connection cable 46 connected to the analysis device 40 to stop or reduce the light output from the output unit 31 of the light source device 30. In addition, the processing unit 45 calculates the intensity of the reference light RefL input to the reference light input unit 42. Furthermore, the processing unit 45 calculates the intensity of the reflected light RL having the same wavelength as the irradiation light (the same wavelength as the reference light RefL) and the intensity of the fluorescence FL having a wavelength different from that of the reference light RefL and the reflected light RL from the light input to the detection light input unit 41. The processing unit 45 transmits a signal representing the calculated result to the display device 50, so that the signal can be displayed on a display panel 52, which will be described later.

[0040] 1, the display device 50 is connected to the analysis device 40 via a display cable 51. The display device 50 receives a display signal from the analysis device 40 via the display cable 51, and can display information for notifying the surgeon on a display panel 52. The display device 50 may include a sound output unit (speaker) for notifying the surgeon by sound.

[0041] Next, an example of a method for treating breast cancer using the treatment system 10 according to the first embodiment will be described with reference to a flowchart of the processing unit 45 shown in Fig. 5. Note that this description does not limit the structure of the treatment system 10.

[0042] First, the operator administers the antibody-photosensitive substance into a blood vessel, into a milk duct B, or into a lymphatic vessel. When the operator administers the antibody-photosensitive substance into a blood vessel, the operator administers the antibody-photosensitive substance intravenously or into an artery. When the operator administers the antibody-photosensitive substance intravenously, the operator inserts a known guidewire (not shown) into a milk duct opening Bo that can reach the milk duct B located near the tumor C shown in FIG. 2 after about 12 to 36 hours from the administration. Next, the operator inserts the base end of the guidewire into the lumen of a catheter 60 (e.g., a microcatheter), and inserts the catheter 60 into the milk duct B from the milk duct opening Bo along the guidewire. After this, the operator removes the guidewire from the catheter 60. When the operator administers the antibody-photosensitive substance locally into an artery that nourishes tumor cells, the operator waits until the antibody-photosensitive substance accumulates on the target cell membrane. When an antibody-photosensitizer is administered locally to the nutrient artery of an organ containing the tumor C to be treated, the time it takes for the antibody-photosensitizer to accumulate on the target cell membrane is shorter than in the case of intravenous administration, and is thought to be, for example, about 5 to 10 minutes.

[0043] Next, the surgeon inserts the shaft portion 21 of the optical device 20 into the catheter 60 from the base end side of the catheter 60. The tip portion of the optical device 20 protrudes from the catheter 60 toward the tip side. Next, the surgeon moves the tip portion of the optical device 20 to the target position while checking, for example, under ultrasound fluoroscopy. The target position is a position that is close to the tumor C and where near-infrared light can be irradiated to the tumor C. When the target position is close to the body surface, the surroundings may be darkened and light serving as a marker may be output from the tip of the optical device 20, so that the position of the tip portion can be directly viewed from the body surface, or may be detected and confirmed by a high-sensitivity camera.

[0044] Next, the operator checks the preparation for treatment, the treatment position, and the setting of the threshold value T. To this end, the operator operates the analysis device 40 that controls the light source device 30, and causes the light source device 30 to output near-infrared rays (step S10). The light source device 30 outputs near-infrared rays having a wavelength of, for example, 689 nm at a predetermined intensity (power) from the output unit 31 and the reference light output unit 32. The reference light RefL output from the reference light output unit 32 is input to the reference light input unit 42 of the analysis device 40. The near-infrared rays output from the output unit 31 of the light source device 30 pass through the input cable 22, the optical circulator 24, and the shaft unit 21, and are irradiated toward the tumor C from the irradiation unit 25 arranged at the tip of the shaft unit 21. The detection unit 26 arranged at the tip of the shaft unit 21 detects light from the outside. The detection unit 26 detects reflected light RL having the same wavelength as the near-infrared light (irradiated light) irradiated from the irradiation unit 25, and fluorescence FL having a wavelength (700 to 705 nm) different from the irradiated light (or reflected light RL) that is emitted by the antibody-photosensitizer excited by receiving the near-infrared light. The light detected by the detection unit 26 is input to the detection light input unit 41 of the analysis device 40 through the shaft unit 21, the optical circulator 24, and the output cable 23. The processing unit 45 of the analysis device 40 receives signals of the reference light RefL, the reflected light RL, and the fluorescence FL (step S11).

[0045] The processing unit 45 of the analysis device 40 calculates the intensity of the reference light RefL received by the reference light input unit 42 and the intensities of the reflected light RL and the fluorescence FL received by the detection light input unit 41 in real time (step S12). Next, as shown in FIG. 3, the processing unit 45 displays the calculated intensities of the reference light RefL, the reflected light RL, and the fluorescence FL on the display panel 52 of the display device 50 in real time (step S13). The operator moves the position of the irradiation unit 25 while watching the display panel 52 to measure the intensity and distribution of the fluorescence FL. When the operator sets a threshold T from the measurement result or changes the threshold T, the operator can operate the analysis device 40 to input the threshold T (step S14). The processing unit 45 of the analysis device 40 sets the input value as the threshold T (step S15). The threshold T may be a predetermined absolute value to be set, or may be a ratio of the intensity of the fluorescence FL to the intensity of the reference light RefL, or a ratio of the intensity of the detected fluorescence FL to the intensity of the reflected light RL. The threshold value T may be set in advance rather than being input by the surgeon during the procedure.

[0046] After measuring the intensity and distribution of the fluorescence FL, the surgeon determines the treatment procedure for the tumor C (e.g., division into multiple treatment sites and threshold value T). Next, the surgeon holds the irradiation unit 25 in a position where it can irradiate near-infrared rays to the site of the tumor C that will be treated first, and operates the analysis device 40 to start the treatment (step S16). When the surgeon starts the treatment, the processing unit 45 starts measuring the irradiation time (step S17).

[0047] When the antibody-photosensitizer accumulated in tumor cells is irradiated with near-infrared light, the antibody-photosensitizer undergoes a photoreaction, emitting fluorescent FL and destroying the tumor cells. Note that the antibody-photosensitizer does not emit fluorescent FL after destroying the tumor cells. Therefore, by measuring the change in the intensity of the detected fluorescent FL in real time, the progress of the photoreaction that destroys the tumor cells can be confirmed.

[0048] As described above, as shown in FIG. 3, the processing unit 45 of the analysis device 40 displays the calculated intensities of the reference light RefL, the reflected light RL, and the fluorescence FL on the display panel 52 of the display device 50 in real time (step S13). The ratio of the reflected light RL to the reference light RefL is approximately constant. Therefore, only one of the reference light RefL or the reflected light RL may be measured. The processing unit 45 judges whether the intensity of the detected fluorescence FL is less than the set threshold T (or is equal to or less than the threshold T) (step S18). If the processing unit 45 judges that the intensity of the fluorescence FL is not less than the threshold T (or is equal to or less than the threshold T), it determines that the progress of the photoreaction that destroys the tumor cells is insufficient, and continues to output the near-infrared rays from the light source device 30, and returns to step S11. If the processing unit 45 judges that the intensity of the fluorescence FL is less than the threshold T (or is equal to or less than the threshold T), it determines that the photoreaction that destroys the tumor cells has progressed sufficiently. Next, the processing unit 45 outputs a threshold reaching signal indicating that the intensity of the fluorescence FL has become less than the threshold value T (or equal to or less than the threshold value T), and transmits the threshold reaching signal to the display device 40, causing the display panel 52 to display it in real time (step S19).

[0049] The intensity of the fluorescence FL may be less than the threshold T (or equal to or less than the threshold T) for a reason that the irradiation is sufficiently performed and the photoreaction has progressed, or that a foreign body such as a body fluid has entered the irradiation site and the fluorescence RL cannot be detected. For this reason, the operator or the processing unit 45 may start the irradiation of near-infrared rays from the light source device 30 after confirming that the illumination light RefL, the reflected light RL, and the fluorescence FL have a certain relationship. Then, during the irradiation of near-infrared rays, if the fluorescence FL decreases without changing the relationship between the reference light RefL and the reflected light RL, the processing unit 45 determines that the irradiation of near-infrared rays and the photoreaction are progressing stably. Also, if the reflected light RL or the reflected light RL and the fluorescence FL are greatly decreased with respect to the reference light RefL during the irradiation of near-infrared rays, the processing unit 45 determines that the irradiation state has changed due to a foreign body. The processing unit 45 may transmit the determined result to the display device 40 and display it on the display panel 52. In this way, the detection result of the reflected light RL may be used to determine that stable irradiation of near-infrared rays for the photoreaction is being performed.

[0050] Next, the processing unit 45 judges whether the irradiation time from the start of output of near-infrared rays is equal to or longer than (or exceeds) a preset minimum irradiation time (step S20). The minimum irradiation time is a minimum irradiation time set to ensure a minimum amount of irradiation. Therefore, after starting output of near-infrared rays from the light source device 30, the processing unit 45 does not stop the irradiation until the irradiation time is equal to or longer than (or exceeds) the minimum irradiation time.

[0051] If the processing unit 45 determines that the irradiation time is not equal to or longer than the minimum irradiation time (or has not exceeded the minimum irradiation time), it continues outputting near-infrared rays from the light source device 30 and returns to step S02. Then, if the processing unit 45 determines that the irradiation time is equal to or longer than the minimum irradiation time (or has exceeded the minimum irradiation time), it causes the display device 50 to display in real time information indicating that the conditions for completing the treatment of the treatment area (irradiation of near-infrared rays) have been met (step S21). This completes the treatment of the initially selected treatment area.

[0052] It is not necessary to set a minimum irradiation time. In this case, when the processing unit 45 determines in step S18 that the intensity of the fluorescence FL is less than the threshold value T (or equal to or less than the threshold value T), it does not perform steps S15 to S16, and causes the display device 50 to display in real time information indicating that the conditions for stopping the output of near-infrared rays have been met (step S21). In step S21, in addition to displaying that the conditions for stopping the output have been met, there may be a function of temporarily stopping the output. When temporarily stopping the output, the light source is stopped or at least a part of the optical path including the input cable 22 is blocked.

[0053] Next, when the operator ends the treatment of the selected treatment site, the operator can select whether to treat another site of the tumor C or to end the treatment of the tumor C by operating the analysis device 40 (step S22). The operator shifts and moves the irradiation unit 25 to a position where the next treatment site can be irradiated with near-infrared rays, and holds it there. After this, the operator starts the treatment of the new treatment site (step S16). Then, the operator measures the change in the intensity of the fluorescence FL in real time, as described above, and performs the treatment with near-infrared rays until the condition for completing the treatment is met (step S21). This allows the operator to treat multiple treatment sites sequentially. When the operator has treated all treatment sites of the tumor C and determined that there are no other treatment sites, the operator operates the analysis device 40 to select whether to end the treatment of the tumor C (step S22). This causes the processing unit 45 to stop the output of near-infrared rays from the light source device 30 (step S23). In this way, the operator can destroy tumor cells distributed over a wide area by alternately repeating the movement of the position of the irradiation unit 25 and the treatment to destroy tumor cells by photoreaction. Finally, the surgeon removes the optical device 20 and the catheter 60 from the milk duct B to complete the procedure. Note that the processing unit 45 may stop the irradiation of near-infrared rays each time the treatment of each selected treatment site is completed, and start the irradiation of near-infrared rays each time the treatment of each selected treatment site is started.

[0054] If the optical device 20 has a certain degree of rigidity and can be pushed into the milk duct B by itself, the catheter 60 and the guide wire do not need to be used when inserting the optical device 20 into the milk duct B. For example, the tip of the optical device 20 may be curved so that it can be directed in any direction within the milk duct B. Alternatively, the tip of the optical device 20 may be formed with a wire-like protrusion protruding therefrom so that it can be easily oriented in the milk duct B.

[0055] 4, when performing treatment, the surgeon may clamp and deform the breast so as to bring the irradiation unit 25 and / or the detection unit 26 closer to the tumor C. The direction in which the breast is clamped can be determined based on the measurement results of the intensity and distribution of the fluorescence FL of the entire tumor C performed before treatment.

[0056] As described above, the treatment system 10 of the first embodiment is a treatment system 10 that irradiates excitation light to antibody-photosensitive substance accumulated in tumor cells in breast cancer tumor cells, and has an optical fiber 27 capable of propagating light between the base end and the tip end, and an optical device 20 equipped with an irradiation section 25 at the tip end capable of irradiating light to the outside and a detection section 26 capable of detecting external light, and the tip end of the optical device 20 can be inserted into the milk duct B from the milk duct opening Bo.

[0057] The treatment system 10 configured as described above can effectively irradiate the antibody-photosensitizer accumulated in the tumor cells with near-infrared light by disposing the irradiation unit 25 and detection unit 26 of the optical device 20 in positions close to the tumor cells in the breast duct B, and can effectively detect the fluorescence FL emitted by the antibody-photosensitizer accumulated in the tumor cells. Therefore, the treatment system 10 can treat the tumor cells while checking the degree of destruction of the tumor cells by irradiation with near-infrared light by detecting the fluorescence FL, thereby improving the treatment effect.

[0058] The treatment system 10 also has an analysis device 40 that is connected to the base end of the optical device 20 and receives and analyzes the light detected by the detection unit 26, and the analysis device 40 calculates the intensity of the fluorescence FL received from the detection unit 26, and when the intensity of the fluorescence FL becomes equal to or less than a threshold T or less than the threshold T, outputs a threshold reaching signal indicating that the intensity of the fluorescence FL becomes equal to or less than the threshold T or less than the threshold T. This enables the treatment system 10 to notify the operator that the intensity of the fluorescence FL has become equal to or less than the threshold T or less than the threshold T, or to stop the irradiation of the excitation light.

[0059] Furthermore, the treatment method in this embodiment is a treatment method in which excitation light is irradiated onto the antibody-photosensitive substance accumulated in breast cancer tumor cells, and includes the steps of administering the antibody-photosensitive substance into a blood vessel, into a milk duct B or into a lymphatic vessel, inserting an optical device 20 having an optical fiber 27 into the milk duct B from the milk duct opening Bo, irradiating excitation light towards the antibody-photosensitive substance accumulated in the tumor cells, and detecting fluorescence FL emitted by the antibody-photosensitive substance irradiated with the excitation light, and the irradiation step and / or detection step are performed by the optical device 20 inserted into the milk duct B.

[0060] The therapeutic method configured as described above can effectively irradiate the antibody-photosensitizer accumulated in breast cancer tumor cells with excitation light and / or detect the fluorescent FL by the optical device 20 inserted near the tumor cells. Therefore, this therapeutic method can treat while checking in real time the degree of destruction of tumor cells caused by irradiation with excitation light by detecting the fluorescent FL, improving the therapeutic effect.

[0061] Moreover, the excitation light is near-infrared light, the optical device 20 has an irradiation unit 25 capable of irradiating near-infrared light and a detection unit 26 capable of detecting external light, and the step of irradiating the excitation light may be performed by the irradiation unit 25, and the step of detecting the fluorescence emitted by the antibody-photosensitizer may be performed by the detection unit 26. As a result, the present treatment method can perform treatment while checking the degree of destruction of tumor cells by irradiation with near-infrared light, thereby improving the therapeutic effect.

[0062] The treatment method also includes a step of comparing the intensity of the fluorescence FL detected by the detection unit 26 with a threshold value T, and a step of changing the position of the irradiation unit 25 capable of irradiating near-infrared rays or stopping the irradiation of near-infrared rays when or after the intensity of the fluorescence FL reaches the threshold value T. This allows the treatment method to treat while checking with high accuracy the degree of destruction of tumor cells caused by irradiation with near-infrared rays by comparing the intensity of the fluorescence FL with the threshold value T. This allows the treatment method to further improve the therapeutic effect.

[0063] Furthermore, the treatment method includes a step of detecting the fluorescence FL emitted by the antibody-photosensitizer irradiated with near-infrared light and confirming the position of the fluorescence FL and the intensity of the fluorescence FL while changing the position of the irradiating unit 25, prior to the step of irradiating the excitation light. This allows the treatment method to accurately grasp the distribution of breast cancer tumor cells, and then effectively destroy them while leaving as few tumor cells as possible behind.

[0064] In addition, in the treatment method, in the step of irradiating excitation light and the step of detecting fluorescence FL, the breast may be deformed to become thinner, and the position of irradiation unit 25 and / or detection unit 26 may be brought closer to the tumor cells in which the antibody-photosensitizer has accumulated. This makes it possible to effectively irradiate the antibody-photosensitizer with excitation light from irradiation unit 25 and / or detect fluorescence FL emitted by the antibody-photosensitizer.

[0065] <Second embodiment> The treatment system 10 of the second embodiment differs from the first embodiment in that, as shown in Figures 6 and 7, the tip of the shaft portion 21 of the optical device 20 has an expansion portion 70 that can be expanded radially, and a sheath 71 that can accommodate the expansion portion 70 by contracting it.

[0066] The shaft portion 21 has an extension portion 70 connected to its tip portion, which can expand and contract in the radial direction (the direction perpendicular to the axis of the shaft portion 21). The extension portion 70 is formed in a mesh shape by a light guide capable of propagating light. The base end of the extension portion 70 is connected to the shaft portion 21, and the tip portion of the extension portion 70 expands to have an outer diameter larger than the outer diameter of the shaft portion 21 in a natural state where no external force is applied. That is, the extension portion 70 is formed in a cylindrical shape so that the inner diameter and the outer diameter expand toward the tip side while having gaps due to being mesh-like in the natural state. The extension portion 70 is formed by weaving a plurality of thin wires 72 with gaps, and the plurality of wires 72 are connected at the tip portion of the extension portion 70 so that they do not unravel.

[0067] The expansion portion 70 is preferably configured to apply as little radial force as possible to the inner wall of the milk duct B during expansion. This can reduce the burden on the milk duct B caused by the expansion of the expansion portion 70. For this reason, the material forming the expansion portion 70 is, for example, a highly elastic rubber material or a thin, flexible thread-like member.

[0068] At least one of the multiple wires 72 forming the extension section 70 may be an optical fiber 27 extending from the shaft section 21 and receiving near-infrared rays. The optical fiber 27 forming at least a part of the extension section 70 includes at least one irradiation section 25 and one detection section 26 in the axial direction of the optical fiber 27. The optical fiber 27 forming at least a part of the extension section 70 may have multiple irradiation sections 25 arranged in the axial direction of the optical fiber 27, or an irradiation section 25 formed long in the axial direction. The optical fiber 27 forming at least a part of the extension section 70 may also have multiple detection sections 26 arranged in the axial direction of the optical fiber 27, or a detection section 26 formed long in the axial direction. A position marker 73 is arranged at the base end of the optical device 20 (for example, the base end of the shaft section 21) so as to match the circumferential positions of the irradiation section 25 and the detection section 26 of the extension section 70. The position marker 73 is used by the surgeon to grasp the circumferential positions of the irradiation unit 25 and the detection unit 26 which are inserted into the milk duct B and cannot be seen by the surgeon.

[0069] The sheath 71 is a cylindrical member capable of housing the shaft portion 21 and the expansion portion 70. As shown in Fig. 6(A), the sheath 71 moves in a distal direction relative to the shaft portion 21 and the expansion portion 70, thereby radially contracting and housing the expansion portion 70. From a state in which the sheath 71 houses the expansion portion 70, the sheath 71 moves in a proximal direction relative to the shaft portion 21 and the expansion portion 70, thereby releasing the expansion portion 70, as shown in Fig. 6(B). As a result, the expansion portion 70 returns to its original expanded shape due to its own elasticity.

[0070] When using the treatment system 10 according to the second embodiment, the surgeon inserts the optical device 20 into the milk duct B from the milk duct opening Bo with the expansion section 70 housed in the sheath 71, as shown in Fig. 6(A). After that, the surgeon moves the sheath 71 in the proximal direction to release the expansion section 70 from the sheath 71, as shown in Figs. 6(B) and 7.

[0071] As a result, the expansion section 70 expands by its own restoring force and comes into contact with the inner wall of the milk duct B or is positioned near the inner wall of the milk duct B. The irradiation section 25 and the detection section 26 are arranged in the expansion section 70. Therefore, since near-infrared rays can be irradiated near the inner wall of the milk duct B, it is possible to suppress the body fluid in the milk duct B that prevents the light from reaching the milk duct B from affecting the irradiation of the light. Therefore, near-infrared rays can be effectively irradiated to the antibody-photosensitizer accumulated in the tumor cells. In addition, since light can be detected near the inner wall of the milk duct B, it is possible to suppress the body fluid in the milk duct B that prevents the light from reaching the milk duct B from affecting the detection of the light. Therefore, the detection section 26 can effectively detect the reflected light RL of the near-infrared rays and the fluorescence FL emitted by the antibody-photosensitizer. The body fluid in the milk duct B can flow through the gaps in the mesh-like expansion section 70. Therefore, the expansion section 70 is likely to expand without being hindered by body fluid and come into contact with the inner wall of the milk duct B or be positioned near the inner wall of the milk duct B.

[0072] Furthermore, by checking the position of the position marker 73 at the base end of the optical device 20, the surgeon can orient the circumferential positions of the irradiation unit 25 and the detection unit 26 in a desired direction.

[0073] As described above, the treatment system 10 according to the second embodiment has the expansion section 70 at the tip of the optical device 20, which is expandable and contractible in the radial direction, and the irradiation section 25 and the detection section 26 are disposed in the expansion section 70. As a result, by expanding the expansion section 70 inside the milk duct B, the irradiation section 25 and the detection section 26 can be disposed near the inner wall of the milk duct B. This reduces the influence of body fluid inside the milk duct B that prevents light from reaching the tumor cells, and allows the irradiation section 25 to effectively irradiate the antibody-photosensitizer accumulated in the tumor cells with near-infrared light, while also effectively detecting the fluorescence FL emitted by the antibody-photosensitizer.

[0074] Moreover, the treatment method in the second embodiment includes a step of expanding the tip of the optical device 20 inserted into the milk duct B, and locating the irradiation unit 25 and / or the detection unit 26 in the vicinity of the inner wall of the milk duct B. This reduces the influence of body fluids in the milk duct B that impede the transmission of light, and makes it possible to effectively irradiate the antibody-photosensitizer with near-infrared rays from the irradiation unit 25 and / or detect the fluorescence FL emitted by the antibody-photosensitizer.

[0075] The structure of the expansion section 70 is not particularly limited. For example, the expansion section 70 may be a so-called self-expandable stent-like member in which a plurality of slit-shaped through holes penetrating from the outer peripheral surface to the inner peripheral surface are formed in a circular tube as a material by laser processing or the like, and the tip portion is shaped in a state in which it is expanded radially outward. In this case, the optical fiber 27 having the irradiation section 25 and the detection section 26 is fixed so as to be wound around the expansion section 70. In addition, the expansion section 70 may be formed of a light guide other than an optical fiber, and may have a structure that can receive near-infrared rays from the optical fiber 27 forming the shaft section 21 and irradiate them to the outside, and can receive light from the outside and propagate the light to the optical fiber 27.

[0076] The expansion section 70 may also include an outer tube 73 that houses the shaft section 21 that includes the optical fiber 27, as in the modified example shown in FIG. 8. The distal end of the expansion section 70 that includes a plurality of wires 72 is fixed to the distal end of the shaft section 21, and the proximal end of the expansion section 70 is fixed to the distal end of the outer tube 73. The expansion section 70 is either a light guide connected to the optical fiber 27 that forms the shaft section 21, or a part of the optical fiber 27. The surgeon can apply a compressive force in the axial direction to the expansion section 70 by moving the outer tube 73 toward the distal end relative to the shaft section 21, as shown in FIG. 8(B). This allows the expansion section 70 to expand radially outward. The surgeon can also contract the expansion section 70 radially inward by moving the outer tube 73 toward the proximal end relative to the shaft section 21, as shown in FIG. 8(A).

[0077] The expansion portion may be one or more wires wound in a spiral (coil) shape, or a balloon that expands when fluid is introduced into it.

[0078] <Third embodiment> As shown in FIG. 9, the treatment system 10 according to the third embodiment differs from the first embodiment in that it separately includes a first optical device 80 having an irradiation unit 25 and a second optical device 90 having a detection unit 26.

[0079] The first optical device 80 has a first shaft portion 81 equipped with an optical fiber 27 that receives near-infrared light from the output portion 31 of the light source apparatus 30, and an irradiation portion 25 that irradiates near-infrared light is disposed at the tip of the first shaft portion 81. The second optical device 90 has a second shaft portion 91 equipped with an optical fiber 27 that propagates light to the detection light input portion 41 of the analysis apparatus 40, and a detection portion 26 that detects external reflected light RL and fluorescence FL is disposed at the tip of the second shaft portion 91.

[0080] When using the treatment system 10 according to the third embodiment, the surgeon inserts the first shaft portion 81 into the milk duct B from the milk duct opening Bo, and places the irradiation unit 25 in a position where the near-infrared rays can be irradiated to the antibody-photosensitizer accumulated in the tumor cells. After that, the surgeon inserts the second shaft portion 91 from the milk duct opening Bo into a milk duct B different from the milk duct B in which the irradiation unit 25 is placed. Next, the surgeon places the detection unit 26 in a position where the fluorescence FL from the tumor cells irradiated with the near-infrared rays can be detected. After that, the surgeon operates the analysis device 40 that controls the light source device 30 to irradiate the near-infrared rays from the irradiation unit 25, and detects the reflected light RL and the fluorescence FL by the detection unit 26. This allows the surgeon to measure the change in the intensity of the detected fluorescence FL in real time and confirm the progress of the photoreaction that destroys the tumor cells.

[0081] As another modified example in which the first optical device 80 and the second optical device 90 are different, the first optical device 80 including the irradiation unit 25 may be inserted into the milk duct B, and the second optical device 90 including the detection unit 26 may be placed on the skin of the breast or the like outside the body. As yet another example, the second optical device 90 including the detection unit 26 may be inserted into the milk duct B, and the first optical device 80 including the irradiation unit 25 may be placed on the skin of the breast or the like outside the body.

[0082] <Fourth embodiment> As shown in FIG. 10, the optical device 100 of the treatment system 10 according to the fourth embodiment may be an OCT catheter that detects reflected light and forms a tomographic image of a biological tissue by optical coherence tomography (OCT). The optical device 100 includes a long outer tube 101, a scanning unit 102 that is disposed in the outer tube 101 and serves as an irradiation unit that irradiates light and a detection unit that detects light, a drive shaft 103 that is disposed in the outer tube 101 and drives the scanning unit 102 to rotate, a drive source 104 that imparts a rotational force to the drive shaft 103, an optical fiber 105 that is disposed inside the drive shaft 103 and rotates together with the drive shaft 103 and is connected to the scanning unit 102, and a control unit 106 that is connected to the optical fiber 105 and creates a tomographic image. The control unit 106 includes a light source device and an analysis device. The control unit 106 controls the drive source 104 to rotate the drive shaft 103 and the scanning unit 102. Then, the control unit 106 can create a circumferential tomographic image surrounding the optical device 100 by irradiating light from the scanning unit 102 and detecting reflected light. This allows the operator to grasp the position and distribution of the tumor C from the sectional image obtained from the OCT catheter 60. Then, the operator uses the control unit 106 to output near-infrared light from the scanning unit 102, which is an irradiating unit, and detects reflected light RL and fluorescence FL from the scanning unit 102, which is a detecting unit. This allows the operator to measure in real time that tumor cells are destroyed by the photoreaction of the antibody-photosensitive substance using the OCT catheter that forms the sectional image. At this time, the scanning unit 102, which is an irradiating unit and a detecting unit, rotates, so that near-infrared light can be output circumferentially so as to surround the optical device 100, and light can be detected circumferentially. Therefore, the optical device 100 can effectively destroy tumor cells in a wide range. It is to be noted that the scanning unit 102 does not have to rotate. Furthermore, the scanning unit 102 may be able to obtain a three-dimensional image of a wide range in the axial direction by rotating while moving inside the outer tube 101 in the axial direction, and destroy tumor cells in a wide range.

[0083] It is preferable that the outer tube 101 be in close contact with the milk duct B so that the antibody-photosensitizer accumulated in the tumor cells can be effectively irradiated with near-infrared light from the scanning unit 102 and the fluorescence FL emitted by the antibody-photosensitizer can be effectively detected by the scanning unit 102. For this reason, it is preferable that the outer diameter of the outer tube 101 is slightly larger than the inner diameter of the milk duct B, or a probe is inserted into the milk duct B before inserting the outer tube 101.

[0084] As a catheter for acquiring a tomographic image of a tissue including a tumor C, an ultrasound (IVUS) catheter may be inserted into the milk duct B instead of an OCT catheter. An ultrasound catheter can acquire a tomographic image to a deeper position than an OCT catheter. Since an ultrasound catheter does not detect by irradiating light, it is used in combination with the optical device 20 of the treatment system 10 according to the first to third embodiments. When using ultrasound, it is preferable to make the ultrasound catheter adhere closely to the inner wall of the milk duct B, since measurement is not possible if there is air between the ultrasound transducer and the object of observation. For this purpose, for example, a thick probe or a balloon filled with liquid may be placed on the surface of the ultrasound catheter.

[0085] As described above, the treatment method in the fourth embodiment includes a step of inserting a catheter for acquiring a tomographic image into the milk duct from the milk duct opening Bo and acquiring a tomographic image of the tissue containing the tumor cells in which the antibody-photosensitizer has accumulated, before the step of irradiating near-infrared light. This allows the present treatment method to accurately grasp the distribution of breast cancer tumor cells, and then to effectively destroy them while leaving as few tumor cells as possible behind.

[0086] The present invention is not limited to the above-described embodiment, and various modifications can be made by those skilled in the art within the technical concept of the present invention.

[0087] For example, as another example of the treatment method, a fluorescent reagent (e.g., ICG (indocyanine green)) having an excitation wavelength different from that of the target antibody-photosensitizer may be administered in advance into the blood vessel, the mammary duct B, or the lymphatic vessel. The timing and place of administration of the fluorescent reagent may be the same as or different from that of the antibody-photosensitizer. This allows not only the antibody-photosensitizer but also the fluorescent reagent to accumulate in the tumor cells. For example, indocyanine green is excited by light with a wavelength of 774 nm to emit fluorescence FL2 with a wavelength of 805 nm. For this reason, the irradiation unit 25 irradiates light including near-infrared light with a wavelength (e.g., 689 nm) that excites the antibody-photosensitizer and light with a wavelength (e.g., 774 nm) that excites a fluorescent reagent different from the antibody-photosensitizer. As a result, as shown in FIG. 11, the processing unit 45 can calculate the intensities of the reference light RefL (e.g., wavelength 689 nm), the reflected light RL (e.g., wavelength 689 nm) having the same wavelength as the near-infrared light irradiated from the irradiation unit 25, the fluorescence FL (e.g., wavelength 704 nm) emitted by the antibody-photosensitizer accumulated in the tumor cells, and the fluorescence FL2 (e.g., wavelength 805 nm) emitted by the fluorescent reagent accumulated in the tumor cells, and display them on the display device 50. Note that when the antibody-photosensitizer receives near-infrared light and undergoes a photoreaction to destroy the tumor cells, it no longer emits the fluorescence FL. This makes it difficult to identify the site where the tumor cells were located by the fluorescence FL. In contrast, even if the antibody-photosensitizer undergoes a photoreaction, the fluorescent reagent does not undergo a chemical change and can therefore emit the fluorescence FL2.

[0088] As another example of a different treatment device and treatment method, photodynamic therapy (PDT) may be performed by administering only a photosensitive substance, such as 5-aminolevulinic acid (ALA), Photofrin (Porfimer sodium), or Laserphyrin, in advance and irradiating the tumor cells with excitation light.

[0089] As described above, the treatment method may include the steps of administering into a blood vessel, a mammary duct B, or a lymphatic vessel a fluorescent reagent that has an excitation wavelength different from that of the antibody-photosensitizer and that can emit fluorescence FL2 at a wavelength different from the fluorescence FL emitted by the antibody-photosensitizer, and irradiating tumor cells with light of the excitation wavelength of the fluorescent reagent and detecting the fluorescence FL2 emitted by the fluorescent reagent that has accumulated in the tumor cells. Even if the antibody-photosensitizer undergoes a photoreaction and no longer emits fluorescence FL, the fluorescent reagent continues to emit fluorescence FL2, and therefore the surgeon can easily recognize that destruction of tumor cells has progressed due to the photoreaction of the antibody-photosensitizer from the fluorescence FL2 emitted by the fluorescent reagent.

[0090] This application is based on Japanese Patent Application No. 2020-059473 filed on March 30, 2020, the disclosures of which are hereby incorporated by reference in their entirety. [Explanation of symbols]

[0091] 10 Treatment System 20, 100 Optical Devices 25 Irradiation unit 26 Detection unit 27 Optical Fiber 30 Light source device 40 Analyzer 50 Display device 70 Extension 80 First Optical Device (Optical Device) 81 First shaft section 90 Second Optical Device (Optical Device) 91 Second shaft section 102 Scanning unit (irradiation unit, detection unit) 105 Optical Fiber 106 Control unit (light source device, analysis device) B Milk duct Bo ductal opening C tumor FL Fluorescence emitted by antibody-photosensitizer Fluorescence emitted by FL2 fluorescent reagent RefL Reference Light RL reflected light

Claims

1. A treatment system for irradiating a photosensitive substance accumulated in breast cancer tumor cells with excitation light, comprising: an optical device including an optical fiber capable of transmitting light between a base end and a tip end, the tip end including an irradiation unit capable of irradiating light to the outside and a detection unit capable of detecting external light; an analysis device connected to a base end of the optical device and configured to receive and analyze the light detected by the detection unit, A tip of the optical device is insertable into the milk duct through an opening of the milk duct; The analysis device calculates the intensity of the fluorescence received from the detection unit, and when the intensity of the fluorescence becomes below or below a threshold, outputs a threshold reaching signal indicating that the intensity of the fluorescence becomes below or below the threshold.

2. a distal end of the optical device having an extension portion capable of expanding and contracting in a radial direction; The treatment system according to claim 1 , wherein the irradiation unit and the detection unit are disposed in the extension unit.

3. 3. The therapeutic system according to claim 1, wherein the photosensitizer is an antibody-photosensitizer bound to an antibody that accumulates in tumor cells.

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