Mlkvy, P. and Messmann, Helmut and Regula, J. and Conio, M. and Pauer, M. and Millson, C. E. and MacRobert, A. J. and Bown, S. G. (1998) Photodynamic therapy for gastrointestinal tumors using three photosensitizers - ALA induced PPIX, Photofrin (R) and MTHPC. A pilot study. NEOPLASMA, 45 (3). pp. 157-161. ISSN 0028-2685,
Full text not available from this repository.Abstract
Photodynamic therapy (PDT) produces localized necrosis with light after prior administration of a photosensitizing drug. As PDT lesions in the gastrointestinal tract heal well, the technique is suitable for repeated endoscopic use. In this study we used PDT to treat benign and malignant gastrointestinal tumors in esophagus, duodenum and rectum in 22 patients, who refused or were not suitable for surgery. Patients were sensitized with 0.15 mg/kg of body weight with mesotetrahydroxyphenylchlorin i.v. m-THPc (2 patients), with 2.0 mg/kg Photofrin(R) i.v. (4 patients) or 60 mg/kg 5-aminolevulinic acid orally ALA (which is converted in vivo to active derivate protoporphyrin TX -PPIX) in fractionated doses (16 patients). Laser treatment was performed 2 days after Photofrin(R), 2 and 4 days after mTHPc and 4 hours after ALA, using a metal vapour laser (628 nm, 50-150 J/cm(2) for ALA and Photofrin(R), 650 nm and 10-15 J/cm2 for mTHPc). Using ALA, the necrosis was only superficial (up to 1.8 mm depth). Four patients treated with Photofrin(R) showed deeper necrosis, in one case of 8 mm colon cancer complete response, in three cases 1-1.5 cm adenomatous polyps involving the ampulla Vateri 50% longer term reduction in size - seen endoscopically. Two patients with rectal villous adenomas treated with mTHPc showed 60-80% reduction in size (observed endoscopically) within few days after PDT, with better effects for treatment carried out 4 rather than 2 days after the sensitization. In all patients the healing was without any complications. Photofrin(R) and mTHPc work better, but cause cutaneous photosensitivity lasting 12 and 5 weeks, respectively. Better results with ALA are possible when using higher drug doses or modified light dosimetry. PDT is a promising treatment for small localized turners in patients unsuitable for surgery, but further work is required to optimize the treatment conditions.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | 5-AMINOLEVULINIC ACID; PROTOPORPHYRIN-IX; DESTRUCTION; PORPHYRINS; CARCINOMA; CHLORINS; CANCER; MUSCLE; MODEL; gastrointestinal tumors; photodynamic therapy; endoscopic therapy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 31 Oct 2023 10:43 |
| Last Modified: | 31 Oct 2023 10:43 |
| URI: | https://pred.uni-regensburg.de/id/eprint/50274 |
Actions (login required)
 |
View Item |
