Individualization of interstitial photodynamic therapy for malignant gliomas

2019 ◽  
Author(s):  
Maximilian Aumiller ◽  
Adrian Rühm ◽  
Maximilian Eisel ◽  
Christian Freymüller ◽  
Herbert Stepp ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Malignant Gliomas ◽  
Interstitial Photodynamic Therapy

scholarly journals Interstitial Photodynamic Therapy Using 5-ALA for Malignant Glioma Recurrences

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1767
Author(s):  
Stefanie Lietke ◽  
Michael Schmutzer ◽  
Christoph Schwartz ◽  
Jonathan Weller ◽  
Sebastian Siller ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Prognostic Factors ◽  
Malignant Glioma ◽  
Treatment Response ◽  
Aminolevulinic Acid ◽  
Malignant Gliomas ◽  
Target Volume ◽  
Risk Profile ◽  
Who Grade ◽  
Interstitial Photodynamic Therapy

Interstitial photodynamic therapy (iPDT) using 5-aminolevulinic acid (5-ALA)-induced protoporphyrin IX (PpIX) as a cytotoxic photosensitizer could be a feasible treatment option for malignant gliomas. In a monocentric cohort of consecutive patients treated between 2006 and 2018, a risk profile analysis of salvage iPDT for local malignant glioma recurrences and associated outcome measures are presented here. It was considered indicated in patients with circumscribed biopsy-proven malignant glioma recurrences after standard therapy, if not deemed eligible for safe complete resection. A 3D treatment-planning software was used to determine the number and suitable positions of the cylindrical diffusing fibers placed stereotactically to ensure optimal interstitial irradiation of the target volume. Outcome measurements included the risk profile of the procedure, estimated time-to-treatment-failure (TTF), post-recurrence survival (PRS) and prognostic factors. Forty-seven patients were treated, of which 44 (median age, 49.4 years, range, 33.4–87.0 years, 27 males) could be retrospectively evaluated. Recurrent gliomas included 37 glioblastomas (WHO grade IV) and 7 anaplastic astrocytomas (WHO grade III). Thirty (68.2%) tumors were O-6-methylguanine-DNA methyltransferase (MGMT)-methylated, 29 (65.9%)—isocitrate dehydrogenase (IDH)-wildtype. Twenty-six (59.1%) patients were treated for their first, 9 (20.5%)—for their second, 9 (20.5%)—for the third or further recurrence. The median iPDT target volume was 3.34 cm3 (range, 0.50–22.8 cm3). Severe neurologic deterioration lasted for more than six weeks in one patient only. The median TTF was 7.1 (95% confidence interval (CI), 4.4–9.8) months and the median PRS was 13.0 (95% CI, 9.2–16.8) months. The 2- and 5-year PRS rates were 25.0% and 4.5%, respectively. The treatment response was heterogeneous and not significantly associated with patient characteristics, treatment-related factors or molecular markers. The promising outcome and acceptable risk profile deserve further prospective evaluation particularly to identify mechanisms and prognostic factors of favorable treatment response.

Stereotactic Intratumoral Photodynamic Therapy for Recurrent Malignant Brain Tumors

Neurosurgery ◽  
1991 ◽  
Vol 29 (5) ◽  
pp. 688-696 ◽  
Author(s):  
Stephen K. Powers ◽  
Sharon S. Cush ◽  
Diana L. Walstad ◽  
Lester Kwock
Keyword(s):  
Photodynamic Therapy ◽  
Magnetic Resonance ◽  
Malignant Gliomas ◽  
Signs And Symptoms ◽  
Resonance Spectroscopy ◽  
Normal Brain ◽  
Hematoporphyrin Derivative ◽  
Neurological Sequelae ◽  
Computed Tomographic ◽  
Before And After

Abstract Photodynamic therapy (PDT) using purified hematoporphyrin derivative and stereotactic intratumorally implanted optical laser fiber(s) was used to treat patients with recurrent malignant gliomas and metastatic melanoma of the brain. Tumor response to PDT was evaluated by recording changes in the volume and pattern of tumor enhancement between computed tomographic and magnetic resonance imaging scans done before and after PDT, metabolic changes in tumor tissue by31 P magnetic resonance spectroscopy, and patient outcome. Toxicity of PDT to brain was evaluated on the basis of changes in the patients' neurological examinations and correlated with changes in brain adjacent to tumor seen on postoperative imaging studies. Dramatic tumor responses to PDT were seen in all gliomas, but no response of tumor to treatment was seen with melanoma. Transient signs and symptoms of increased peritumoral cerebral edema caused by PDT were seen in all patients. Two patients suffered permanent neurological sequelae, monocular blindness and a partial visual field defect, as a result of treatment. Two patients with recurrent anaplastic astrocytomas remain in remission at 45 and 35 weeks after PDT. We conclude that intratumoral photoradiation therapy of hematoporphyrin derivative-photosensitized malignant gliomas effectively produces necrosis of the solid component of malignant gliomas: however, intratumoral photoradiation may not reach the portion of tumor that invades normal brain.

scholarly journals 362P Influence of the expression of ABCG2 transporters on the results of photodynamic therapy in malignant gliomas

2021 ◽  
Vol 32 ◽  
pp. S523
Author(s):  
A. Rynda ◽  
V. Olyushin ◽  
D. Rostovtsev ◽  
J. Zabrodskaya
Keyword(s):  
Photodynamic Therapy ◽  
Malignant Gliomas

Optimizing interstitial photodynamic therapy with custom cylindrical diffusers

2018 ◽  
Vol 12 (1) ◽  
pp. e201800153 ◽  
Author(s):  
Abdul-Amir Yassine ◽  
Lothar Lilge ◽  
Vaughn Betz
Keyword(s):  
Photodynamic Therapy ◽  
Interstitial Photodynamic Therapy

mTHPC mediated interstitial photodynamic therapy of recurrent nonmetastatic base of tongue cancers: Development of a new method

Head & Neck ◽  
2012 ◽  
Vol 34 (11) ◽  
pp. 1597-1606 ◽  
Author(s):  
Baris Karakullukcu ◽  
Heike J. Nyst ◽  
Robert L. van Veen ◽  
Frank J. P. Hoebers ◽  
Olga Hamming-Vrieze ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
New Method ◽  
Base Of Tongue ◽  
Interstitial Photodynamic Therapy

Photodynamic Therapy of Malignant Gliomas

2018 ◽  
pp. 1-13 ◽  
Author(s):  
Sadao Kaneko ◽  
Shin Fujimoto ◽  
Hideshi Yamaguchi ◽  
Toru Yamauchi ◽  
Tetsuya Yoshimoto ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Malignant Gliomas
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