Photodynamic Therapy (PDT) and fluorescent diagnostics (FD) using Photosense was provided in 50 patients with head and neck cancer T1-3 stage, in 89 patients with skin cancer, using Radaclorine (RC) in 42 patients with T1-4 stage basal cell carcinoma (BCC),in 6 patients with oral cancer. Detection of borders of tumor, intensity of accumulation of photosensitizers in tumor, normal tissues were done by Spectral-fluorescent Complex. We've got fluorescence of a11 tumors and additional fluorescence zones were found with cytological verification. We used semiconductive lasers: Milon - λ = 660+2nm, light dose 200 - 300 J/cm2 and Biospec (λ=672+2nm), multiple laser surface and interstitial irradiation with total light dose till 400-600 J/cm2. After PDT with PS in head and neck cancer we've had complete response (CR) in 66.0% and partial response (PR) in 30.0%, with RC CR in BCC T1-2NOMO - 92.9%, in recurrencies CR - 60,6%, PR - 39,4%. The efficacy of PDT with PS was higher (CR - 86.7%, PR - 13,3%) and the recurrence rate in 6 months lower. Our experience show pronounced efficacy of PDT for head and neck tumors of different localization and histology, FD is providing diagnostically significant information, demonstrated high sensitivity and specificity.
Photodynamic therapy (PDT) and fluorescent diagnostics (FD) with Radaclorine (RadaPharma, Russia) (RC) have been provided in 32 patients with T1-4 stage basal cell carcinoma (BCC) and in 81 patients with Photsense. Pharmacocynetic studies with detecting the borders of tumor growth and intensity of accumulation of photosensizers in tumor, normal tissues and visualization have been done by Spectral-fluorescent Complex and spectranalyser LESA-01 (He-Ne-laser, λ=633nm). We've got fluorescence of all tumors and additional fluorescence zones were found, cytological verification of BCC was got in most of cases. The fluorescent signs of RC in normal skin were found till 5 days after injection. As a source of light for PDT we used simeconductive lasers: Milon - λ = 660+2nm, light dose was 200-300 J/cm2 and Biospec (λ+672+2nm), multiple laser surface and interstitial irradiation was performed 24 hours after PS injection with total light dose till 400-600 J/cm2. 2 months after PDT with RC complete response (CR) in 65.6% of cases, partial response-in 34.4% of cases. The efficacy of PDT with PS was higher (CR-84.0%, PR-14.8%). Our experience show pronounced efficacy of PDT with RC for BCC without side effects and very short skin toxicity.
Photodynamic Therapy (PDT) and fluorescent diagnostics (FD) using Photosense have been provided in 26 patients with breast cancer (BC) and in 108 patients with skin metastases of BC. In 22 patients with T1-T2N0M0 primary tumor PDT was preoperative treatment, with radical mastectomy 7-10 days after PDT. 4 patients had residual tumor after radiotherapy. FD was fulfilled with spectranalyser. We used semiconductive laser for PDT-λ=672+2nm, P=1,5 W, interstitial irradiation 2-24 hours after PS injection in light dose 150-200 J/cm3 in patients with primary tumor and multiple surface irradiations (1-4) with interval 24-48 hours and total light dose 400-600 J/cm2 for metastases. Partial regression of tumor with pathomorphosis of 2-4 degree has been found in 23 cases in first group. Treating metastases we had overall response rate of 86,9% with complete response (CR) in 51,5% and partial response in 35,4%. In a year after PDT in 52 patients with CR we had CR in 36,6%, local recurrences in 23,1%, progression (distant [lung or bone] metastasis) in 40,4% of cases. Our experience show pronounced efficacy of FD for detecting tumor borders and PDT for treating BC as preoperative modality and as palliation in cases of recurrencies.
Photodynamic Therapy (PDT) using photosensitizer Photosense (PS) in dose 0.5 mg per kg of body weight have been provided in 24 patients with breast cancer. In 22 patients with T1-T2N0M0 primary tumor was treated as the preoperative treatment, radical mastectomy has been fulfilled 7-10 days after PDT with subsequent histological examination. 2 patients had recurrencies of breast cancer with lymph node metastases after radiotherapy. Fluorescent diagnostics of tumor, accumulation of PS in tumor, adjacent tissue, skin before and during PDT was fulfilled with spectranalyzer LESA-01. We used semiconductive laser for PDT - λ = 672+2nm, P=1,5 W, interstitial irradiation 2-24 hours after PS injection has been done in light dose 150-200 J/cm3, 1-3 irradiations with interval 24-48 hours and total light dose 400-600 J/cm3 depending mostly of size and fluorescent data. Partial regression of tumor with pathomorphosis of 2-4 degrees has been found in 19 cases. Our experience shows pronounced efficacy of PDT for treating breast cancer as preoperative modality and as palliation in cases of recurrencies.
Photodynamic Therapy (PDT) and fluorescent diagnostics (FD) using photosensitizers Photosense (Aluminium Phtalocyanine, (NIOPIC, Russia)(PS) and Alasense have been provided in 101 patients with breast cancer as a multicenter study. All patients had recurrences of breast cancer (skin metastases) after combined treatment, chemotherapy and radiotherapy. FD of tumor with detecting of subclinical sites, accumulation of PS in tumor, adjacent tissue, skin before and during PDT was fulfilled. Multiple surface irradiations were carried on with interval 24-72 hours (semiconductive laser - (lambda) =672+2nm) in light does 100J/cm2 and total light does 300-900 J/cm2. 2 months after PDT we had overall response rate of 86,87% with complete response (CR) in 51,48% and partial response in 35,39%. During year after PDT in 52 patients with CR we had CR in 36,6% local recurrences in 23,1%, progression (distant (lung or bone) metastasis) in 40,4% of cases. Our experience show pronounced efficacy of PDT for skin metastases of breast cancer.
The efficiency of photodynamic therapy (PDT) using 5- aminolevulinic acid (5-ALA) is essentially determined by an optimal choice of sensitization means, among which the application method is one of the most perspective due to high permeability of a skin for 5-ALA. The aim of present work is optimization of sensitization process with ALA. We have used the possibility of 5-ALA transparency in applicator (outside of tissue) while protoporphyrin-IX, formed in sensitized tissue, has sufficient absorption for providing PDT. We have developed 5-ALA containing applicator on the basis of transparent biodegradable polymers, which serve as a programmed source of 5-ALA in the zone of their contact with pathological tissue. The investigations carried out on mice with the solid form of leucosis p-388, have shown that developed applicator provides effective sensitization of pathological tissue, supporting high concentration of photosensitizer in tissue during the whole time of application (up to week). The experiments in vivo have demonstrated high efficiency of PDT. The preliminary clinical researches allow to draw a conclusion about its perspectivity for photodynamic treatment of skin malignancies.
This paper deals with photosensitizer quantification in patients undergoing photodynamic therapy. Both fluorescence and diffuse reflectance spectroscopy were applied to evaluate concentration of sulphonated aluminum phthalocyanine in different tissues. The mixtures of Intralipid, blood and photosensitizer with different concentrations were used as standard samples to solve the problem in question. While fluorescence method is more sensitive and more convenient to apply in clinics, the absorption technique may be applied to non fluorescent dyes and used to evaluate the shifts in adsorption peak position due to interaction of dye with tissues. Finally, the concentration dynamics of non fluorescent dye (cobalt phthalocyanine) in patients was obtained with the use of absorption method alone.
Photodynamic Therapy (PDT) using second-generation photosensitizer Aluminium Phtalocyanine (NIOPIC, Russia) (PS) in dose 0.5-0.8 mg per kg of body weight have been provided in 15 patients with breast cancer. In 5 patients with T2-T3NOMO primary tumor was treated as the preoperarive treatment, radical mastectomy has been fulfilled after PDT with subsequent histological examination. 10 patients had local recurrencies of breast cancer after combined treatment, chemotherapy and radiotherapy. Fluorescent diagnostics of tumor, accumulation of PS in tumor, adjacent tissue before and during PDT was fulfilled. For PDT semiconductive laser -X=672+2nm, P=1,5 W was used. Treating primary tumor interstitial irradiation has been done in light dose l5OJIcm3. In patients with skin metastases multiple surface irradiations were provided with interval 24-72 hours and total light dose 400-900 J/cm2. In cases of preoperative PDT pathomorphosis of different degree has been found in all cases. In patients with advanced skin recurrencies of breast cancer partial regression of tumor has been got in 2 monthes after PDT or progression with lung or bone metastasis. In 5patients with early skin metastases in 80% complete responce've been got 2 monthes after treatment with recurrencies in 6 monthes in 60% patients. Our experience show pronounced efficacy of PDT for treating breast cancer.
The aim of the study was to determine the efficacy of photodynamic therapy (PDT) of tumors of different localization and histology with new photosensitizer aluminum sulfonated phthalocyanine (Photosense, Russia). PDT have been provided in 106 patients with different tumors. The initial dose (2.0 - 2.5 mg/kg) of PHS was significantly reduced till 0.5 - 0.8 mg/kg during clinical trials because of phototoxicity. The results of PDT, side effects and ways of their correction and prevention, as well as possibility to work out less toxic regimes of PDT with photosense, choice of laser and type of irradiation are discussed. Efficacy of PDT depended on tumor size and it's histological type. Using low doses of PHS we've reduced the phototoxicity of sensitizer with the same direct effectiveness of treatment. Undesirable changes in plasma content of antioxidants by means of high pressure liquid chromatography have been found in patients after PHS injection. Influence of short-term and long-term supplementation with beta- carotene and vitamin E on this parameters are discussed.
This paper deals with the results of clinical trials for sulfated aluminum phthalocyanine (PHS) (Photosens, Russia) and Photogeme (PG) in Russia. The results of photodynamic therapy (PDT) of head and neck tumors (HNT), side effects and ways of their correction and prevention, as well as possibility to work out less toxic regimes of PDT with photosense, choice of laser and type of irradiation are discussed. PDT have been provided in 79 patients with different head and neck tumors. Efficacy of PDT depended on tumor size and its histological type. Undesirable changes in plasma content of antioxidants by means of high pressure liquid chromatography (HLPC) have been found in patients after PHS injection. Influence of short-term and long-term supplementation with beta-carotene and vitamin E on this parameters are discussed.
We have determined the efficacy of PDT and depth of necrosis for advanced tumors. Clinical results of PDT have shown that it is possible to get the depth of tumors necrosis till 20 mm using lasers providing high power density of laser irradiation. One of the possible models can be enlightenment of sensitizer during laser irradiation.
Photodynamic therapy (PDT) using phtalocyanine Al, has been provided in 5 patients with advanced breast cancer (ABC). In 3 patients with ABC T4NO-2MO have been provided preoperative PDT, in 2 cases with T4N1Mx PDT have been done after previous combined treatment for subcutaneous metastases. Multiple lesions were treated in one patient. As a source of light we have used quantoscope (scanning electron beam semiconductive laser, and solid laser with doubled frequency. Combined surface and interstitial laser irradiation has been provided in cases of preoperative PDT. Preliminary results of our study show the pronounced efficacy of PDT for subcutaneous metastases of breast cancer and possibility of providing preoperative PDT for advanced breast cancer.
The data about absorption spectra properties of the photosensitized tumor tissues in vivo are very important for the evaluation photosensitizer concentration and influence of the chemical environment on photosensitizer properties in tissue. This information will help one in the appropriate choosing of irradiation light dose and wavelength in the photodynamic therapy (PDT) treatment. The interaction of photosensitizer with tumor tissue may change its absorption spectrum. Moreover the light irradiation during PDT treatment can also affect the photosensitizer chemical structure and hence change its absorption spectrum. The simple technique based on the measurement of reflection spectra by means of fiber optic spectrometer has been developed. This method allows one to evaluate the contribution to the tissue absorption properties due to the presence of photosensitizer in it. The absorption spectra of photosensitized normal and tumor tissues presented in this paper has been obtained during PDT sessions of head and neck tumors. The photosensitizer -- sulphonated aluminum phthalocyanine (Photosence) (NIOPIC, Russia) -- has been injected intravenously in doses 0.5 - 2 mg per kg of body weight. It has been observed that absorption properties of this photosensitizer are not changed significantly in tissue as compared to that of in solution. The absorption spectra widening and red shift (4 nm) has been noticed. The qualitative pharmocokinetic of photosensitizer based on absorption spectra measurements is presented.
This paper deals with the results of stage 1 clinical trials for sulfated aluminum phthalocyanine (PHS) (Photosens, Russia) in 1994-1996. The results of photodynamic therapy (PDT) of head and neck tumors (HNT), side effects and ways of their correction and prevention, as well as changes in doses of injected photosensitizer (PS), regimes of light irradiation, choice of laser and type of irradiation (surface or interstitial) are discussed. PDT have been provided in 42 patients (93 tumor sites) with different head and neck tumors. Fluorescent diagnostics of tumor, accumulation of PS in tumor, adjacent tissue has been fulfilled. Total 78 PDT sessions have been done. As a source of light we used: quantoscope, solid laser, krypton laser, tunable dye laser, He-Ne-laser. In 38 tumor sites (21 patients) -- 40.8% -- we had clinical response, in 27 tumor sites (16 patients) -- 29.0% -- we had partial response, in 28 tumor sites (8 patients) -- 30.2% -- we had no response. Our experience shows pronounced efficacy of PDT for HNT, except of melanoma. Providing PDT twice with the interval 24 - 72 hours when retention of PS is sufficient for treatment, did additive effect to the tumor, but didn't increase adjacent tissue damage.
Photodynamic therapy (PDT) using quantoscope (scanning electron-beam pumped semiconductor laser, (lambda) equals 670 plus or minus 2 nm, P equals 10 W) and Phtalocyanine Al as photosensitizer (PS) have been provided in nine patients (27 tumor sites) with spread skin malignancies (basal cell, squamous cell cancer, melanoma, metastases of breast cancer) and cancer of the lip T2 N0 M0. During PDT power density has been from 200 to 450 mW/cm2, light doses ranging from 150 to 700 J/cm2. We have fulfilled diagnostic of tumor after injection of PS and have controlled treatment using spectral- fluorescent video complex. In five patients (23 sites) we had complete clinical response and in four patients (4 sites) partial response after PDT. Results of our study show that use of scanning electron-beam-pumped semiconductor laser is promising in the treatment of spread skin malignancies.
Photodynamic therapy (PDT) using quantoscope (scanning electron-beam pumped semiconductor laser, (lambda) equals 670 +/- 2 nm, P equals 10 W) and Phthalocyanine Al as photosensitizer (PS) have been provided in nine patients (27 tumor sites) with spread skin malignancies (basal cell, squamous cell cancer, melanoma, metastases of breast cancer) and cancer of lip T1 - T2 N0 M0. During PDT power density has been from 200 to 450 mW/cm2, light doses ranging from 150 to 700 J/cm2. We have fulfilled diagnostic of tumor after injection of PS and have controlled treatment using Spectral-Fluorescent Video Complex. In five patients (23 sites) we had complete clinical response and in four patients (4 sites) partial response after PDT. Results of our study show that using of scanning electron- beam pumped semiconductor laser is perspective in treating of spread skin malignancies.
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