Photodynamic Therapy with Hematoporphyrin Derivative in the Treatment of Superficial Transitional-Cell Carcinoma of the Bladder

Abstract

Photodynamic therapy involves light-induced destruction of tumors containing a photosensitizer such as hematoporphyrin derivative. We conducted a collaborative study to evaluate the efficacy of this form of therapy in treating superficial transitional-cell carcinoma of the bladder. Thirty-seven patients were evaluated and 20 were selected for treatment. A total of 50 papillary tumors and 3 areas of carcinoma in situ were treated. All except two tumors were smaller than 2.5 cm. Assessments for treatment response and toxicity were carried out three months after treatment. The initial diagnosis of one patient was revised after the biopsy material was reviewed, and this patient was not included in the analysis. Complete eradication of all tumors was observed in 9 of 19 patients (47 percent), including those with carcinoma in situ. In the remaining 10 of these 19 patients, 13 tumors could not be eradicated (the overall eradication rate was 37 of 50 tumors [74 percent]), but 9 of the 10 patients had a reduction in tumor size, number, or both of 50 percent or more. We conclude that photodynamic therapy is useful in the treatment of superficial transitional-cell carcinoma of the bladder, but controlled trials will be required to define its place in the treatment of cancer.

Photodynamic therapy of cancer: An update

“…In one study, focal HPD-mediated PDT was used to treat 50 superficial bladder transitional cell carcinomas (TCC) in 37 patients and achieved a 74% complete response rate. 196 Another study used HPD-mediated PDT to treat the entire bladder wall for 34 patients with refractory carcinoma in situ (CIS) of the bladder and achieved a 73.5% complete response rate at 3 months. 197 However, by 2 years, 77.8% of these patients experienced disease recurrence.…”

Changes produced in the urothelium by traditional and newer therapeutic procedures for bladder cancer

“…51 52 Other findings include spindle cell artifact of urothelial cells and dystrophic calcification. [53][54][55] The photosensitiser accumulates also in the stroma and in the vessel wall, suggesting tumour ischaemia as a possible mechanism of action. In fact, early morphological changes show intravascular coagulation and adjacent tumour cell necrosis.…”

Cell Damage and Death by Autoschizis in Human Bladder (RT4) Carcinoma Cells Resulting from Treatment with Ascorbate and Menadione

“…In addition, immunostimulants such as bacillus Calmette-Guérin administered alone or in conjunction with interferon [33][34][35][36][37] or with mitomycin C [40,41], interleukin-12 [41], or even garlic extract [42] have been used. In some cases, instillation chemotherapy with these potent compounds has been combined with photodynamic therapy using hematoporphyrin [43] or with titanium oxide [44].…”