Palliation of esophageal malignancy with photoradiation therapy

Abstract

Seven patients with severe or complete obstruction of the esophagus by malignancy were treated with photoradiation after presensitization of the tumor with intravenous hematoporphyrin derivative. The 625 to 635‐nm therapeutic light was delivered from a tunable dye argon laser system coupled through quartz fibers, passed through the biopsy channel of a flexible esophagoscope, with local anesthesia. All tumors (adeno, squamous, and melanoma) responded, and swallowing was improved. Although tumor is still present, one patient is 11 months from initial treatment and is eating a regular diet. Another patient is 8 months from initial treatment and has no dysphagia. One patient died of aspiration of gastric tube feedings and 3 others died of their disease at 3 weeks, 3 months, and 6 months, respectively, from their initial treatment. Another patient died 11 months from his initial treatment due to a cardiac arrhythmia. During the 11 months after his initial treatment he continued to eat a regular diet.

Protoporphyrin IX fluorescence photobleaching is a useful tool to predict the response of rat ovarian cancer following hexaminolevulinate photodynamic therapy

“…HAL is a new promising lipophilic derivative of the naturally occurring heme precursor 5-ALA [46]. In addition to its good tumor selectivity, 5-ALA-induced PpIX has several supplementary advantages over conventional photosensitizing agents, including limited systemic toxicity and low skin photosensitization 24-48 hours after administration.…”

“…These two wavelengths could have been chosen according to the absorption spectrum of the PpIX and they were shown to be as effective on producing tumors. Historically, using red light for PDT has been dictated by the late diagnosis of inoperable bulky tumors and the necessity to reach the deep layers of these tumors [45,46]. It is the wavelength with the deepest penetration.…”

Combination of photodynamic therapy + immunotherapy + chemotherapy in murine leukiemia

“…The most widely studied PDT drugs both in experimental and clinical trials have been hematoporphyrin derivative and Photofrin (a complex mixture of monomeric and oligomeric porphyrins). PDT, utilizing the Photofrin (Ph), has been used clinically for palliation of obstructive lesions of the esophagus [4] and the tracheobronchial tree [5] , for treatment of bladder Due to their role in cell adhesion and antigen presentation, some of the PDT-induced stress proteins may participate in the development of inflammatory/immune response manifested by this therapy. A strong inflammatory reaction is a central event in the mechanism of PDT -mediated tumor destruction with the release of a wide variety of potent mediators like vasoactive substances, components of the complement cascades, cytokines ( IL-6, IL-1β,IL-2,tumor necrosis factor-α and granulocyte colony-stimulating factor) growth factors and other immunoregulators [11,12,13].…”

Using white light during photodynamic therapy: visualization only or treatment?

“…This observation is all the more interesting as it clearly demonstrates that white light might become a viable alternative to the 630 nm diode laser (now currently used almost exclusively). Historically, this was dictated by the original clinical evaluations of PDT for palliative treatment (inoperable bulky tumors) [15,16]. To reach the deep layers of these tumors, red light was required as shown in Fig.…”