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

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

Fluorescence-guided resections and photodynamic therapy for malignant gliomas using 5-aminolevulinic acid

2005 ◽  
Author(s):  
Herbert G. Stepp ◽  
Tobias Beck ◽  
Wolfgang Beyer ◽  
Thomas Pongratz ◽  
Ronald Sroka ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Aminolevulinic Acid ◽  
Malignant Gliomas

scholarly journals NI-7 Diffusion-weighted imaging for monitoring acute response and recurrence after photodynamic therapy in malignant gliomas

2021 ◽  
Vol 3 (Supplement_6) ◽  
pp. vi19-vi19
Author(s):  
Yuichi Fujita ◽  
Hiroaki Nagashima ◽  
Kazuhiro Tanaka ◽  
Mitsuru Hashiguchi ◽  
Tomoo Itoh ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Local Recurrence ◽  
Malignant Glioma ◽  
Diffusion Weighted Imaging ◽  
Malignant Gliomas ◽  
Distant Recurrence ◽  
Acute Response ◽  
Diffusion Weighted ◽  
Hyperintense Signal ◽  
Apparent Diffusion

Abstract Background Photodynamic therapy (PDT) subsequent to surgical tumor removal is a novel light-activated localized treatment for malignant glioma. Although PDT provides effective local control, even PDT cannot completely suppress local recurrence of malignant glioma. We previously reported that the acute response of malignant glioma to PDT could be detected as linear hyperintense signals on diffusion-weighted imaging (DWI) and a decline in apparent diffusion coefficient (ADC) values that were asymptomatic and transient. However, their long-term clinical significance has not yet been examined. This study aimed to clarify the link between the hyperintense signal on DWI as an acute response and recurrence after PDT in malignant glioma. Methods Thirty consecutive patients (16 men, 14 women; median age 60.5 years) underwent PDT for malignant glioma at our institution between 2017 and 2020. We analyzed signal changes on DWI after PDT and the link between these findings and the recurrence pattern. Results In all patients, linear hyperintense signals of 5–7 mm on DWI were detected at the surface of the resected cavity from day 1 after PDT. These changes matched the PDT-irradiated area and disappeared in about 30 days without any neurological deterioration. Of the 30 patients, 19 (63%) exhibited recurrence: local recurrence in 10 (33%), distant recurrence in 1 (3%), and dissemination in 8 (27%). All local recurrences arose from areas that did not show a hyperintense signal on DWI obtained on day 1 after PDT. Patients with distant recurrence or dissemination tended to have uninterrupted hyperintense signal on DWI obtained on day 1 after PDT. Conclusion The local recurrence in malignant glioma after PDT occurred in the areas without hyperintense signal on DWI as the acute response to PDT. This characteristic finding could aid in the monitoring of not only PDT-irradiated area but also local recurrence site after PDT.

scholarly journals Photodynamic therapy in the treatment of intracranial gliomas: A review of current practice and considerations for future clinical directions

2015 ◽  
Vol 08 (01) ◽  
pp. 1530005 ◽  
Author(s):  
Carl J. Fisher ◽  
Lothar Lilge
Keyword(s):  
Clinical Trials ◽  
Photodynamic Therapy ◽  
Survival Time ◽  
Malignant Gliomas ◽  
Survival Rates ◽  
Standard Of Care ◽  
Therapeutic Index ◽  
Current Standard ◽  
Significant Survival ◽  
Tumor Volume Reduction

Invasive grade III and IV malignant gliomas remain difficult to treat with a typical survival time post-diagnosis hovering around 16 months with only minor extension thereof seen in the past decade, whereas some improvements have been obtained towards five-year survival rates for which completeness of resection is a prerequisite. Optical techniques such as fluorescence guided resection (FGR) and photodynamic therapy (PDT) are promising adjuvant techniques to increase the tumor volume reduction fraction. PDT has been used in combination with surgical resection or alternatively as standalone treatment strategy with some success in extending the median survival time of patients compared to surgery alone and the current standard of care. This document reviews the outcome of past clinical trials and highlights the general shift in PDT therapeutic approaches. It also looks at the current approaches for interstitial PDT and research options into increasing PDT's glioma treatment efficacy through exploiting both physical and biological-based approaches to maximize PDT selectivity and therapeutic index, particularly in brain adjacent to tumor (BAT). Potential reasons for failing to demonstrate a significant survival advantage in prior PDT clinical trials will become evident in light of the improved understanding of glioma biology and PDT dosimetry.

scholarly journals ALA-PpIX mediated photodynamic therapy of malignant gliomas augmented by hypothermia

PLoS ONE ◽  
2017 ◽  
Vol 12 (7) ◽  
pp. e0181654 ◽  
Author(s):  
Carl J. Fisher ◽  
Carolyn Niu ◽  
Warren Foltz ◽  
Yonghong Chen ◽  
Elena Sidorova-Darmos ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Malignant Gliomas

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.

scholarly journals Liposomal Lapatinib in Combination with Low-Dose Photodynamic Therapy for the Treatment of Glioma

2019 ◽  
Vol 8 (12) ◽  
pp. 2214 ◽  
Author(s):  
Carl Fisher ◽  
Girgis Obaid ◽  
Carolyn Niu ◽  
Warren Foltz ◽  
Alyssa Goldstein ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Cell Lines ◽  
Malignant Gliomas ◽  
Protoporphyrin Ix ◽  
Growth Factor Receptor ◽  
In Vivo Studies ◽  
Epidermal Growth

Background: Malignant gliomas are highly invasive and extremely difficult to treat tumours with poor prognosis and outcomes. Photodynamic therapy (PDT), mediated by Gleolan®, has been studied previously with partial success in treating these tumours and extending lifetime. We aim to determine whether combining PDT using ALA-protoporphyrin IX (PpIX) with a liposomal formulation of the clinical epidermal growth factor receptor (EGFR) inhibitor, lapatinib, would increase the anti-tumour PDT efficacy. Methods: Lapatinib was given in vitro and in vivo 24 h prior to PDT and for 3–5 days following PDT to elicit whether the combination provided any benefits to PDT therapy. Live-cell imaging, in vitro PDT, and in vivo studies were performed to elucidate the effect lapatinib had on PDT for a variety of glioma cell lines and as well as GSC-30 neurospheres in vivo. Results: PDT combined with lapatinib led to a significant increase in PpIX accumulation, and reductions in the LD50 of PpIX mediated PDT in two EGFR-driven cell lines, U87 and U87vIII, tested (p < 0.05). PDT + lapatinib elicited stronger MRI-quantified glioma responses following PDT for two human glioma-derived tumours (U87 and GSC-30) in vivo (p < 0.05). Furthermore, PDT leads to enhanced survival in rats following treatment with lapatinib compared to lapatinib alone and PDT alone (p < 0.05). Conclusions: As lapatinib is approved for other oncological indications, a realization of its potential combination with PDT and in fluorescence-guided resection could be readily tested clinically. Furthermore, as its use would only be in acute settings, long-term resistance should not pose an issue as compared to its use as monotherapy.

scholarly journals DWI for Monitoring the Acute Response of Malignant Gliomas to Photodynamic Therapy

2019 ◽  
Author(s):  
Y. Fujita ◽  
T. Sasayama ◽  
K. Tanaka ◽  
K. Kyotani ◽  
H. Nagashima ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Malignant Gliomas ◽  
Acute Response
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