Does new photosensitizer improve photodynamic therapy in advanced esophageal carcinoma?

Background and Objective Polyhematoporphyrin (Photosan®) as sensitizers for photodynamic therapy (PDT) in advanced esophageal cancer carry the risk of prolonged photosensitivity of the skin. New sensitizers such as 5‐aminolaevulinic acid (ALA) with low rates of skin phototoxicity appear to be promis...

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Published inLasers in surgery and medicine Vol. 29; no. 4; pp. 323 - 327
Main Authors Maier, Alfred, Tomaselli, Florian, Matzi, Veronika, Rehak, Peter, Pinter, Hans, Smolle-Jüttner, Freyja M.
Format Journal Article
LanguageEnglish
Published New York John Wiley & Sons, Inc 01.01.2001
Wiley-Liss
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Abstract Background and Objective Polyhematoporphyrin (Photosan®) as sensitizers for photodynamic therapy (PDT) in advanced esophageal cancer carry the risk of prolonged photosensitivity of the skin. New sensitizers such as 5‐aminolaevulinic acid (ALA) with low rates of skin phototoxicity appear to be promising alternatives. The aim of this study was to evaluate the efficacy of ALA compared to Photosan® for PDT in advanced esophageal carcinoma regarding phototoxicity of the skin, reduction of dysphagia, tumor stenosis, and tumor length and Karnovsky performance status. Study Design/Materials and Methods After diagnostic work‐up, photosensitization was done in 22 patients with ALA (60 mg/kg body weight, oral, 6–8 hours prior to PDT) and in 27 patients with Photosan® (2 mg/kg body weight, i.v., 48 hours before PDT). The light dose was calculated as 300 J/cm fibre tip. Light at 630 nm was applied using a pumped dye laser. In both groups, additional hyperbaric oxygenation was applied at a level of 2 absolute atmospheric pressure. Results Improvement regarding dysphagia, stenosis diameter, and tumor length could be obtained in both treatment arms with a significant difference in favour of the Photosan®‐group, P = 0.02; P = 0.0000; and P = 0.000014, respectively. The Karnovsky performance status also improved in both groups and showed no significant difference (P = 0.12). The median survival time for the ALA‐group was 8.0 months, compared with 9.0 months for the Photosan® group. No sunburn or other major treatment related complication occurred in both treatment arms. Thirty‐day mortality was 0%. Conclusion Despite the limitations of a non‐randomized study, photosensitzation with Photosan® seems to be more effective in PDT of advanced esophageal carcinoma compared to ALA. Lasers Surg. Med. 29:323–327, 2001. © 2001 Wiley‐Liss, Inc.
AbstractList Abstract Background and Objective Polyhematoporphyrin (Photosan ® ) as sensitizers for photodynamic therapy (PDT) in advanced esophageal cancer carry the risk of prolonged photosensitivity of the skin. New sensitizers such as 5‐aminolaevulinic acid (ALA) with low rates of skin phototoxicity appear to be promising alternatives. The aim of this study was to evaluate the efficacy of ALA compared to Photosan ® for PDT in advanced esophageal carcinoma regarding phototoxicity of the skin, reduction of dysphagia, tumor stenosis, and tumor length and Karnovsky performance status. Study Design/Materials and Methods After diagnostic work‐up, photosensitization was done in 22 patients with ALA (60 mg/kg body weight, oral, 6–8 hours prior to PDT) and in 27 patients with Photosan ® (2 mg/kg body weight, i.v., 48 hours before PDT). The light dose was calculated as 300 J/cm fibre tip. Light at 630 nm was applied using a pumped dye laser. In both groups, additional hyperbaric oxygenation was applied at a level of 2 absolute atmospheric pressure. Results Improvement regarding dysphagia, stenosis diameter, and tumor length could be obtained in both treatment arms with a significant difference in favour of the Photosan ® ‐group, P  = 0.02; P  = 0.0000; and P  = 0.000014, respectively. The Karnovsky performance status also improved in both groups and showed no significant difference ( P  = 0.12). The median survival time for the ALA‐group was 8.0 months, compared with 9.0 months for the Photosan ® group. No sunburn or other major treatment related complication occurred in both treatment arms. Thirty‐day mortality was 0%. Conclusion Despite the limitations of a non‐randomized study, photosensitzation with Photosan ® seems to be more effective in PDT of advanced esophageal carcinoma compared to ALA. Lasers Surg. Med. 29:323–327, 2001. © 2001 Wiley‐Liss, Inc.
Background and Objective Polyhematoporphyrin (Photosan®) as sensitizers for photodynamic therapy (PDT) in advanced esophageal cancer carry the risk of prolonged photosensitivity of the skin. New sensitizers such as 5‐aminolaevulinic acid (ALA) with low rates of skin phototoxicity appear to be promising alternatives. The aim of this study was to evaluate the efficacy of ALA compared to Photosan® for PDT in advanced esophageal carcinoma regarding phototoxicity of the skin, reduction of dysphagia, tumor stenosis, and tumor length and Karnovsky performance status. Study Design/Materials and Methods After diagnostic work‐up, photosensitization was done in 22 patients with ALA (60 mg/kg body weight, oral, 6–8 hours prior to PDT) and in 27 patients with Photosan® (2 mg/kg body weight, i.v., 48 hours before PDT). The light dose was calculated as 300 J/cm fibre tip. Light at 630 nm was applied using a pumped dye laser. In both groups, additional hyperbaric oxygenation was applied at a level of 2 absolute atmospheric pressure. Results Improvement regarding dysphagia, stenosis diameter, and tumor length could be obtained in both treatment arms with a significant difference in favour of the Photosan®‐group, P = 0.02; P = 0.0000; and P = 0.000014, respectively. The Karnovsky performance status also improved in both groups and showed no significant difference (P = 0.12). The median survival time for the ALA‐group was 8.0 months, compared with 9.0 months for the Photosan® group. No sunburn or other major treatment related complication occurred in both treatment arms. Thirty‐day mortality was 0%. Conclusion Despite the limitations of a non‐randomized study, photosensitzation with Photosan® seems to be more effective in PDT of advanced esophageal carcinoma compared to ALA. Lasers Surg. Med. 29:323–327, 2001. © 2001 Wiley‐Liss, Inc.
Polyhematoporphyrin (Photosan) as sensitizers for photodynamic therapy (PDT) in advanced esophageal cancer carry the risk of prolonged photosensitivity of the skin. New sensitizers such as 5-aminolaevulinic acid (ALA) with low rates of skin phototoxicity appear to be promising alternatives. The aim of this study was to evaluate the efficacy of ALA compared to Photosan for PDT in advanced esophageal carcinoma regarding phototoxicity of the skin, reduction of dysphagia, tumor stenosis, and tumor length and Karnovsky performance status. After diagnostic work-up, photosensitization was done in 22 patients with ALA (60 mg/kg body weight, oral, 6-8 hours prior to PDT) and in 27 patients with Photosan (2 mg/kg body weight, i.v., 48 hours before PDT). The light dose was calculated as 300 J/cm fibre tip. Light at 630 nm was applied using a pumped dye laser. In both groups, additional hyperbaric oxygenation was applied at a level of 2 absolute atmospheric pressure. Improvement regarding dysphagia, stenosis diameter, and tumor length could be obtained in both treatment arms with a significant difference in favour of the Photosan-group, P = 0.02; P = 0.0000; and P = 0.000014, respectively. The Karnovsky performance status also improved in both groups and showed no significant difference (P = 0.12). The median survival time for the ALA-group was 8.0 months, compared with 9.0 months for the Photosan group. No sunburn or other major treatment related complication occurred in both treatment arms. Thirty-day mortality was 0%. Despite the limitations of a non-randomized study, photosensitzation with Photosan seems to be more effective in PDT of advanced esophageal carcinoma compared to ALA.
Author Tomaselli, Florian
Smolle-Jüttner, Freyja M.
Maier, Alfred
Matzi, Veronika
Rehak, Peter
Pinter, Hans
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Issue 4
Keywords Human
Acyltransferases
Carcinoma
Photodynamic therapy
Enzyme
Transferases
Esophageal disease
Malignant tumor
5-Aminolevulinate synthase
Esophagus
Association
Performance requirement
Secondary effect
Phototoxicity
Digestive diseases
Advanced stage
Photosensitizer
Language English
License CC BY 4.0
Copyright 2001 Wiley-Liss, Inc.
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PublicationYear 2001
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Snippet Background and Objective Polyhematoporphyrin (Photosan®) as sensitizers for photodynamic therapy (PDT) in advanced esophageal cancer carry the risk of...
Polyhematoporphyrin (Photosan) as sensitizers for photodynamic therapy (PDT) in advanced esophageal cancer carry the risk of prolonged photosensitivity of the...
Abstract Background and Objective Polyhematoporphyrin (Photosan ® ) as sensitizers for photodynamic therapy (PDT) in advanced esophageal cancer carry the risk...
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SubjectTerms Adenocarcinoma - drug therapy
Adenocarcinoma - mortality
Adenocarcinoma - pathology
Aged
Aged, 80 and over
Aminolevulinic Acid - adverse effects
Aminolevulinic Acid - therapeutic use
Biological and medical sciences
Carcinoma, Squamous Cell - drug therapy
Carcinoma, Squamous Cell - mortality
Carcinoma, Squamous Cell - pathology
Deglutition Disorders - drug therapy
Deglutition Disorders - pathology
Dermatitis, Phototoxic - etiology
Diseases of the digestive system
esophageal cancer
Esophageal Neoplasms - drug therapy
Esophageal Neoplasms - mortality
Esophageal Neoplasms - pathology
Female
Hematoporphyrins - adverse effects
Hematoporphyrins - therapeutic use
Humans
Karnofsky Performance Status
Male
Medical sciences
Middle Aged
Photochemotherapy - adverse effects
photodynamic therapy
Photosensitizing Agents - adverse effects
Photosensitizing Agents - therapeutic use
Pilot Projects
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Survival Rate
Treatment Outcome
Title Does new photosensitizer improve photodynamic therapy in advanced esophageal carcinoma?
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https://onlinelibrary.wiley.com/doi/abs/10.1002%2Flsm.1124
https://www.ncbi.nlm.nih.gov/pubmed/11746109
Volume 29
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