Skip to main content
PMC home page
British Journal of Cancer logoLink to British Journal of Cancer
. 1993 Jun;67(6):1398–1403. doi: 10.1038/bjc.1993.259

Interstitial photodynamic therapy. Clinical experience with diffusing fibres in the treatment of cutaneous and subcutaneous tumours.

C P Lowdell 1, D V Ash 1, I Driver 1, S B Brown 1
PMCID: PMC1968517  PMID: 8512824

Abstract

Interstitial photodynamic therapy has a number of potential advantages over superficial treatment. We have treated 50 subcutaneous and cutaneous tumours interstitially, in nine patients. An additional 22 tumours in the same patients, were treated by superficial PDT. Patients received 1.5-2.0 mg kg-1 of polyhaematoporphyrin and 72 h later underwent treatment using a copper vapour dye laser producing red light at 630 nm. All interstitial treatments were delivered using cylindrical diffusing fibres and a wide range of light doses (5-1500 J cm-3). The complete response rate for all tumours treated interstitially was 52%, rising to 81% in those patients who received 2.0 mg kg-1 PHP and light doses in excess of 500 J cm-3. The overall incidence of skin necrosis was 32% and was 79% in those treated with light doses of greater than 500 J cm-3. The incidence of skin necrosis with interstitial PDT is lower than that seen with superficial photodynamic therapy but higher volumetric light doses are required to produce tumour complete responses. All treatments were well tolerated and volumes of tumour up to 60 cm3 were successfully treated. The penetration depth of 630 nm light in human breast cancer tissue was determined as 4 mm. Little true tumour tissue selectivity was detected by analysis of porphyrin levels in biopsy material.

Full text

PDF
1403

Images in this article

1400Figure 1
on p.1400

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ash D., Brown S. B. Photodynamic therapy--achievements and prospects. Br J Cancer. 1989 Aug;60(2):151–152. doi: 10.1038/bjc.1989.239. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Barr H., Krasner N., Boulos P. B., Chatlani P., Bown S. G. Photodynamic therapy for colorectal cancer: a quantitative pilot study. Br J Surg. 1990 Jan;77(1):93–96. doi: 10.1002/bjs.1800770132. [DOI] [PubMed] [Google Scholar]
  3. Barr H., Tralau C. J., Boulos P. B., MacRobert A. J., Tilly R., Bown S. G. The contrasting mechanisms of colonic collagen damage between photodynamic therapy and thermal injury. Photochem Photobiol. 1987 Nov;46(5):795–800. doi: 10.1111/j.1751-1097.1987.tb04850.x. [DOI] [PubMed] [Google Scholar]
  4. Barr H., Tralau C. J., MacRobert A. J., Krasner N., Boulos P. B., Clark C. G., Bown S. G. Photodynamic therapy in the normal rat colon with phthalocyanine sensitisation. Br J Cancer. 1987 Aug;56(2):111–118. doi: 10.1038/bjc.1987.166. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Castro D. J., Abergel R. P., Johnston K. J., Adomian G. E., Dwyer R. M., Uitto J., Lesavoy M. A. Wound healing: biological effects of Nd:YAG laser on collagen metabolism in pig skin in comparison to thermal burn. Ann Plast Surg. 1983 Aug;11(2):131–140. doi: 10.1097/00000637-198308000-00007. [DOI] [PubMed] [Google Scholar]
  6. Cowled P. A., Forbes I. J. Photocytotoxicity in vivo of haematoporphyrin derivative components. Cancer Lett. 1985 Aug;28(1):111–118. doi: 10.1016/0304-3835(85)90099-0. [DOI] [PubMed] [Google Scholar]
  7. Dougherty T. J. Photodynamic therapy (PDT) of malignant tumors. Crit Rev Oncol Hematol. 1984;2(2):83–116. doi: 10.1016/s1040-8428(84)80016-5. [DOI] [PubMed] [Google Scholar]
  8. Driver I., Lowdell C. P., Ash D. V. In vivo measurement of the optical interaction coefficients of human tumours at 630 nm. Phys Med Biol. 1991 Jun;36(6):805–813. doi: 10.1088/0031-9155/36/6/008. [DOI] [PubMed] [Google Scholar]
  9. Fingar V. H., Henderson B. W. Drug and light dose dependence of photodynamic therapy: a study of tumor and normal tissue response. Photochem Photobiol. 1987 Nov;46(5):837–841. doi: 10.1111/j.1751-1097.1987.tb04856.x. [DOI] [PubMed] [Google Scholar]
  10. Gilson D., Ash D., Driver I., Feather J. W., Brown S. Therapeutic ratio of photodynamic therapy in the treatment of superficial tumours of skin and subcutaneous tissues in man. Br J Cancer. 1988 Nov;58(5):665–667. doi: 10.1038/bjc.1988.282. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Gilson D., Dixon B., Ash D. V., Vernon D., Brown S. B. The response of a rodent fibrosarcoma to superficial/interstitial photochemotherapy, chemotherapy or radiotherapy. Radiother Oncol. 1990 Jul;18(3):271–279. doi: 10.1016/0167-8140(90)90063-3. [DOI] [PubMed] [Google Scholar]
  12. Gomer C. J., Dougherty T. J. Determination of [3H]- and [14C]hematoporphyrin derivative distribution in malignant and normal tissue. Cancer Res. 1979 Jan;39(1):146–151. [PubMed] [Google Scholar]
  13. Henderson B. W., Waldow S. M., Mang T. S., Potter W. R., Malone P. B., Dougherty T. J. Tumor destruction and kinetics of tumor cell death in two experimental mouse tumors following photodynamic therapy. Cancer Res. 1985 Feb;45(2):572–576. [PubMed] [Google Scholar]
  14. Kato H., Konaka C., Kawate N., Shinohara H., Kinoshita K., Noguchi M., Ootomo S., Hayata Y. Five-year disease-free survival of a lung cancer patient treated only by photodynamic therapy. Chest. 1986 Nov;90(5):768–770. doi: 10.1378/chest.90.5.768. [DOI] [PubMed] [Google Scholar]
  15. Levendag P. C., Marijnissen H. P., de Ru V. J., Versteeg J. A., van Rhoon G. C., Star W. M. Interaction of interstitial photodynamic therapy and interstitial hyperthermia in a rat rhabdomyosarcoma--a pilot study. Int J Radiat Oncol Biol Phys. 1988 Jan;14(1):139–145. doi: 10.1016/0360-3016(88)90061-2. [DOI] [PubMed] [Google Scholar]
  16. Mang T. S., Dougherty T. J. Time and sequence dependent influence of in vitro photodynamic therapy (PDT) survival by hyperthermia. Photochem Photobiol. 1985 Nov;42(5):533–540. doi: 10.1111/j.1751-1097.1985.tb01606.x. [DOI] [PubMed] [Google Scholar]
  17. McKenzie A. L. How may external and interstitial illumination be compared in laser photodynamic therapy? Phys Med Biol. 1985 May;30(5):455–460. doi: 10.1088/0031-9155/30/5/008. [DOI] [PubMed] [Google Scholar]
  18. Robinson P. J., Carruth J. A., Fairris G. M. Photodynamic therapy: a better treatment for widespread Bowen's disease. Br J Dermatol. 1988 Jul;119(1):59–61. doi: 10.1111/j.1365-2133.1988.tb07101.x. [DOI] [PubMed] [Google Scholar]
  19. Star W. M., Marijnissen H. P., van den Berg-Blok A. E., Versteeg J. A., Franken K. A., Reinhold H. S. Destruction of rat mammary tumor and normal tissue microcirculation by hematoporphyrin derivative photoradiation observed in vivo in sandwich observation chambers. Cancer Res. 1986 May;46(5):2532–2540. [PubMed] [Google Scholar]
  20. Tralau C. J., Barr H., Sandeman D. R., Barton T., Lewin M. R., Bown S. G. Aluminum sulfonated phthalocyanine distribution in rodent tumors of the colon, brain and pancreas. Photochem Photobiol. 1987 Nov;46(5):777–781. doi: 10.1111/j.1751-1097.1987.tb04847.x. [DOI] [PubMed] [Google Scholar]
  21. Wilson B. C., Patterson M. S. The physics of photodynamic therapy. Phys Med Biol. 1986 Apr;31(4):327–360. doi: 10.1088/0031-9155/31/4/001. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES