Recurrent lung cancer with endobronchial obstruction after surgical resection due to lung cancer may lead to severe dyspnea, respiratory insufficiency and sudden death. Many palliative modalities including partial excision of endobronchial tumor, insertion of stent, and evaporation with laser, have been used for endobronchial obstruction due to recurrent endobronchial lung cancer. In photodynamic therapy (PDT), photosensitizer named photofrin, is infused intravenously at 48 hours before PDT, and diode laser of an appropriate wavelength is applied to induce destruction of tumor mass with 200~250 J/cm2. We report 2 cases of treatment using PDT for endobronchial obstruction due to recurrent endobronchial lung cancer after surgical resection.
Death, Sudden ; Dihematoporphyrin Ether ; Dyspnea ; Lasers, Semiconductor ; Lung Neoplasms* ; Lung* ; Photochemotherapy* ; Respiratory Insufficiency ; Stents

OBJECTIVE: The objective of this study was to determine the photodynamic therapeutic response of U-87 human glioma cell in vitro as well as in the nude rat xenograft model using photofrin as photosensitizer. MATERIAL AND METHOD: U-87 cells were cultured on 96-well culture plates, photofrin(Quadralogic Technologies Inc., Vancouver, Canada) was added into the cell culture medium at concentration of 1ng/ml, 2.5ng/ml, 5ng/ml, 10ng/ml and 20ng/ml. 24 hour after drug treatment, cells were treated with optical(632nm) irradiation of 100mJ/cm2, 200mJ/cm2 and 400mJ/cm2. Photofrin(12.5mg/kg, i.p.) was administered to 28 nude rats containing intracerebral U-87 human glioma as well as 26 normal nude rats. 48 hours after administration, animals were treated with optical irradiation(632nm) of 35J/cm2, 140J/cm2 and 280J/cm2 to exposed tumor and normal brain. The photofrin concen-tration was measured in tumor and normal brain in a separate population of animals. RESULTS: By MTT assay, there was 100% cytotoxicity at any dose of photofrin with optical irradiation of 200mJ/cm2 and 400mJ/cm2. But at the optical irradiation of 100mJ/cm2 cells were killed in dose dependent manner 28.5%, 49.1%, 54.4%, 78.2%, and 84.6% at concentration of 1ng/ml, 2.5ng/ml, 5ng/ml, 10ng/ml and 20ng/ml, respectively. Dose dependent PDT lesions in both tumor and normal brain were observed. In the tumor lesion, only superficial tissue damage was found with optical irradiation of 35J/cm2. However, in the optical irradiation group of 140J/cm2 and 280J/cm2 the volume of lesions was measured of 7.2mm3 and 14.0mm3 for treatment at 140J/cm2 and 280J/cm2, respectively. The U-87 bearing rats showed a photofrin concentration in tumor tissue of 6.53+/-2.16ng/g, 23 times higher than that found in the contralateral hemisphere of 0.28+/-0.15ng/g. CONCLUSION: Our data indicate that the U-87 human glioma in vitro and in the xenografted rats is responsive to PDT. At these doses, a reproducible injury can be delivered to human glioma in this model. Strategies to spare the normal brain collateral damage are being studied.
Animals ; Brain ; Brain Neoplasms ; Cell Culture Techniques ; Dihematoporphyrin Ether* ; Glioma* ; Heterografts ; Humans* ; Photochemotherapy ; Rats ; Rats, Nude

Photodynamic therapy has been widely used in the treatment of various cancerous diseases. However, photodynamic therapy with a photosensitizer can cause a photosensitivity reaction on the skin. We report a case of a 64-year-old woman diagnosed with photosensitivity reaction after photodynamic therapy using the photosensitizer, porfimer. She presented to the emergency room with a skin rash on her face, neck, and both upper and lower extremities nine days after the photodynamic therapy. She denied any outdoor activity during that period. After administration of systemic corticosteroid and anti-histamine, her skin lesions resolved completely within seven days.
Dihematoporphyrin Ether ; Emergencies ; Exanthema ; Female ; Humans ; Lower Extremity ; Middle Aged ; Neck ; Papilloma ; Photochemotherapy ; Skin

This paper reviews the use of photodynamic therapy (PDT) in patients with Barrett's esophagus and esophageal carcinoma. We describe the history of PDT, mechanics, photosensitizers for PDT in patients with esophageal disease. Finally, we discuss its utility and limitations in this setting.
Aminolevulinic Acid ; Barrett Esophagus ; Dihematoporphyrin Ether ; Esophageal Diseases ; Esophageal Neoplasms ; Humans ; Mechanics ; Photochemotherapy ; Photosensitizing Agents ; Triazenes

The brief history of photodynamic therapy (PDT) research has been focused on photosensitizers (PSs) and light delivery was introduced recently. The appropriate PSs were developed from the first generation PS Photofrin (QLT) to the second (chlorins or bacteriochlorins derivatives) and third (conjugated PSs on carrier) generations PSs to overcome undesired disadvantages, and to increase selective tumor accumulation and excellent targeting. For the synthesis of new chlorin PSs chlorophyll a is isolated from natural plants or algae, and converted to methyl pheophorbide a (MPa) as an important starting material for further synthesis. MPa has various active functional groups easily modified for the preparation of different kinds of PSs, such as methyl pyropheophorbide a, purpurin-18, purpurinimide, and chlorin e6 derivatives. Combination therapy, such as chemotherapy and photothermal therapy with PDT, is shortly described here. Advanced light delivery system is shown to establish successful clinical applications of PDT. Phtodynamic efficiency of the PSs with light delivery was investigated in vitro and/or in vivo.
Chlorophyll ; Dihematoporphyrin Ether ; Family Characteristics ; Light ; Photochemotherapy ; Photosensitizing Agents ; Porphyrins ; Triazenes

Biliary papillomatosis is a rare disease with a high risk of recurrence and malignant transformation. Therapeutic options include partial hepatectomy, Whipple's procedure and liver transplantation. If there is no surgical option left due to several reasons, local palliative procedures such as biliary stenting and drainage for the treatment of cholestasis are considered, but tumor growth cannot be influenced. Photodynamic therapy might be a new additional, palliative option for patients with biliary papillomatosis who are not eligible for surgery. Benign biliary stricture is a rare complication of photodynamic therapy. We report here a case of a 63-year-old male who developed benign biliary stricture after photodynamic therapy using the photosensitizer photofrin.
Cholestasis ; Constriction, Pathologic ; Dihematoporphyrin Ether ; Drainage ; Hepatectomy ; Humans ; Liver Transplantation ; Male ; Middle Aged ; Papilloma ; Photochemotherapy ; Rare Diseases ; Recurrence ; Stents

Although the surgical treatment of early esophageal cancer is a well-known curative modality, less invasive endoscopic methods have attracted significant attention recently on account of the fewer postoperative complications, better quality of life and preservation of the integrity of the esophagus. Among the various endoscopic techniques employed, photodynamic therapy (PDT) has been used to allow the selective destruction of malignant tissue through a photochemical effect after the administration of a photosensitizer for curative and palliative treatment purposes. This report describes a case of a 73-year-old man with early esophageal cancer, which had been diagnosed by fluorodeoxyglucose-positron emission tomography (FDG-PET) and endoscopy and a long history of chronic pulmonary diseases such as emphysema and radiation fibrosis. The patient was cured successfully with photodynamic therapy using porfimer sodium as the photosensitizer.
Aged ; Dihematoporphyrin Ether ; Emphysema ; Endoscopy ; Esophageal Neoplasms* ; Esophagus ; Humans ; Lung Diseases ; Palliative Care ; Photochemotherapy* ; Postoperative Complications ; Quality of Life ; Radiation Pneumonitis

Photodynamic therapy (PDT) is a non-invasive treatment for cancer that works through a photochemical effect after the administration of a photosensitizer. At first, PDT had been used for the relief of obstructive symptoms caused by exophytic esophageal cancer or for control of tumor overgrowth. Recently, several investigators have reported the use of PDT in early esophageal cancer with encouraging results. This report describes a case of a 52-year-old man with early esophageal cancer, who had a long history of liver cirrhosis with esophageal varix. The patient was treated successfully with PDT using porfimer sodium as the photosensitizer. PDT is an alternative to surgical treatment of early esophageal cancer, especially in patients with liver cirrhosis.
Dihematoporphyrin Ether ; Esophageal and Gastric Varices ; Esophageal Neoplasms ; Humans ; Liver ; Liver Cirrhosis ; Middle Aged ; Photochemotherapy ; Research Personnel ; Triazenes

OBJECTIVE: The management of cervical intraepithelial neoplasia (CIN) and early invasive cancer of the uterine cervix is very difficult to approach, especially in case of young woman who wants to preserve her fertility. Conization of the cervix may have various kinds of disadvantage. The objective of this clinical retrospective study is to investigate the therapeutic effects and clinical efficacy of photodynamic therapy (PDT) including combined chemo-photodynamic therapy in patients with pre-malignant CIN and malignant invasive cervical cancer. METHODS: Total number of PDT trial case was 50 cases and total number of patient was 22 patients who registered to PDT clinic. We used photogem sensitizer and 632 nm diode laser in early two cases. After then we performed PDT using photofrin sensitizer and 630 nm diode laser in other cases. We used flat-cut, microlens, cylindrical diffuser, and interstitial type optic fibers in order to irradiate the lesions. 240 J/cm² energy was irradiated to the lesions. RESULTS: CIN 2 were 4 cases (18.2%) and CIN 3 were 15 (68.2%) and invasive cervical cancer were 3 (13.6%). Complete remission (CR) was found in 20 patients (91%). One case of 19 patients with CIN lesion recurred at 18 months after PDT treatment. CR was found in 18 cases in the patients with CIN lesions (95%). CR was found in 2 cases in the patients with invasive cervical cancer (67%). CONCLUSION: Our data showed that CR rate was fantastic in CIN group (95%). This study suggests that PDT can be recommended as new optimistic management modality on the patients with pre-malignant CIN lesions including carcinoma in situ and relatively early invasive cancer of the uterine cervix. Combined chemo-photodynamic therapy is essential in case of invasive cervical cancer. For the young age group who desperately want to preserve their fertility and have a healthy baby, PDT can be a beacon of hope.
Carcinoma in Situ ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Conization ; Dihematoporphyrin Ether ; Female ; Fertility ; Hope ; Humans ; Lasers, Semiconductor ; Photochemotherapy* ; Retrospective Studies ; Therapeutic Uses ; Treatment Outcome* ; Uterine Cervical Neoplasms

OBJECTIVETo evaluate the tumor cell-killing effect of photodynamic therapy against human esophageal cancer cells in vitro and identify the main factors affecting the effect.

METHODSHuman esophageal cancer Eca-109 cells were incubated for 24 h in vitro with hematoporphyrin derivative (HpD) and Photofrin at different concentrations prior to exposure to a light energy density of 15 J/cm(2) delivered from a DIOMED 630 PDT system. The cell killing effect was also evaluated for different HpD concentrations combined with 3 light energy densities (10, 30, and 50 J/cm(2)), respectively. The cell survival rate was measured using MTT assay, and fluorescence spectrometry was used to detect the intracellular photosensitizer fluorescence of the tumor cells after incubation with HpD for 4 h.

RESULTSThe cell survival rate after incubation with the two photosensitizers at different concentrations were significantly different, and under the 3 different light energy densities, incubation of the cells with different HpD concentrations also resulted in significantly different cell survival rates (P<0.05). At the 4 low photosensitizer concentrations and with different light energy densities, the cell survival rates were similar (P>0.05), but the 4 higher photosensitizer concentrations resulted in significant difference in the cells survival (P<0.05). Correlation analysis showed that the intracellular photosensitizer concentration was positively correlated to the photosensitizer concentrations in cell incubation (r=0.997).

CONCLUSIONWhen the light source remains constant, the light energy density, the kinds of photosensitizers and their concentrations are the main factors affecting the Eca-109 cell-killing effect of PDT.

Cell Line, Tumor ; Cell Survival ; Dihematoporphyrin Ether ; pharmacology ; Esophageal Neoplasms ; drug therapy ; Hematoporphyrin Derivative ; pharmacology ; Hematoporphyrin Photoradiation ; Humans ; Light ; Photosensitizing Agents ; pharmacology