Photodynamic therapy (PDT) is a promising new modality that utilizes the combination of a photosensitizing chemical and visible light for the management of various solid malignancies, including gastrointestinal (GI) cancer. PDT has some advantages over chemotherapy in terms of its greater safety and lower toxicity in the treatment of malignant lesions. However, PDT has not been used widely for treating upper GI cancer due to its relatively low cost-effectiveness and anatomical characteristics of the GI system. Nevertheless, PDT may be an effective alternative therapy for early upper-GI cancer patients who are at a high risk of curative surgical resection or systemic chemotherapy. In some clinical studies, PDT for various upper GI cancer showed positiveresults. To improve the efficacy of PDT for upper GI cancer, development of photosensitezer and light delivery system is needed.
Humans ; Light ; Photochemotherapy ; Triazenes

Topical photodynamic therapy (PDT) via topical 5-aminolevulinic acid (ALA) is potentially useful for the treatment of basal cell carcinoma. However, as a photosensitizer used in PDT, methyl aminolevulinate (MAL) can replace ALA, because MAL has more advantages than ALA. We treated two patients with basal cell carcinoma using MAL-PDT. Topical MAL-PDT may be a safe and effective treatment modality for basal cell carcinoma.
Carcinoma, Basal Cell ; Humans ; Photochemotherapy ; Triazenes

Photodynamic therapy (PDT) is a light based therapy used to ablate tumors. As practiced in oncology a photosensitizing agent is applied and then activated by a specific wavelength and energy of light. This light energy in the presence of oxygen will lead to the creation of the photodynamic reaction which is cyto and vasculo toxic. This paper will review the mechanisms of action of PDT and how they may be manipulated to improve clinical outcome in cancer patients.
Humans ; Light ; Oxygen ; Photochemotherapy ; Photosensitizing Agents ; Triazenes

Several cases of photodynamic therapy (PDT) for the curative treatment of early gastric cancer have recently been reported. However, PDT has been performed in only limited cases because it is impossible to determine the pathologic subtype or stage of the malignant lesion after the procedure. Nevertheless, PDT combined with endoscopic submucosal dissection (ESD) is expected to enhance the accuracy of the pathologic assessment and enable more effective, safe treatment for early gastric cancer. Furthermore, PDT may exert a complementary and synergetic effect on ESD for the atypical forms of early gastric cancer. From this background, we report here on a case of early gastric cancer that mimicked submucosal tumor, and this was removed by ESD, and then this was followed by adjuvant PDT. The patient had a high risk for operation due to his old age and comorbidity. After the procedure, he achieved complete remission and he is currently under follow up: he is without recurrence of tumor one year after ESD.
Comorbidity ; Humans ; Photochemotherapy ; Recurrence ; Stomach Neoplasms ; Triazenes

BACKGROUND: Photodynamic therapy (PDT) in the treatment of warts is known to be a relatively effective and safe cure. However, the pain, which occurs during being exposed to a light source and after its exposure, is being reported to be the most frequent and serious limitation in this therapy. OBJECTIVE: The purpose of this study is to examine whether the level of pain can be lowered, by comparing EMLA(R), which is a topical anesthesia, with placebo, during topical ALA-PDT, and to try to compare the range and characteristics in pain. METHODS: Twenty two patients with common warts were treated with ALA-PDT twice in the interval of 4 weeks, and were divided into two groups by the random distribution table. The distribution was made so that the patients, who used EMLA(R) as the topical anesthesia given at the first visit, could use a placebo at the second visit, and so that the patients who used placebo at the first visit, could use EMLA(R) at the second visit. Thus, a randomized, double-blind, placebo-controlled crossover study was carried out. The pain was evaluated during the treatment, right after the treatment, and one day after the treatment by using Visual Analogue Scale (VAS). Also four different ranges of the pain and its six characteristics were evaluated. RESULTS: Of the 22 patients with common warts who underwent this study. 1 patient, was completely cured after the first visit, and did not participate further in the study. The data of the patients with complete recovery wasn't included in the final statistical analysis. As a result of the evaluation of pain, the mean VAS score that was measured during the treatment, right after the treatment, and one day after the treatment was measured to be a little lower in the case of applying EMLA(R) versus placebo, but a statistically significant difference was not observed. Regarding the degree of pain, regardless of applying EMLA(R), most patients felt painful locally on the surface, and the majority complained of burning and shooting pain. CONCLUSION: Dermatologists tend to routinely apply EMLA(R), prior to a procedure in order to decrease pain. However, as a result of this research, the routine use of EMLA(R) given at PDT is thought to be unreasonable.
Anesthesia ; Burns ; Cross-Over Studies ; Humans ; Light ; Photochemotherapy ; Triazenes ; Warts

BACKGROUND: Photodynamic therapy (PDT) is useful for treating basal cell carcinoma (BCC), and the incidence of nodular type BCC is high among Koreans. However, only one case on the treatment of nodular BCC using methyl aminolevulinate (MAL)-PDT has been reported in Korea. OBJECTIVE: We investigated the efficacy and tolerability of PDT for treating nodular BCC in Korean patients. METHODS: Fifteen patients with nodular BCC were treated. We conducted three MAL-PDT sessions separated by a 1 week interval and assessed the clinical therapeutic effects after 3 months. Then, we performed a histopathological assessment of the lesions in patients who showed complete clinical responses (CR) and surgical procedures for lesions in patients who showed no clinical response (NR). We prescribed three more MAL-PDT sessions to the patients who showed partial clinical responses (PR), and decided whether to carry out a histopathological evaluation or to treat with surgery according to the clinical therapeutic assessment after 3 months. RESULTS: After the first three MAL-PDT sessions, three patients showed CR, eight patients showed PR, and four patients showed NR. One of the eight patients, who had been treated repeatedly, showed CR. CONCLUSION: BCC occurs mainly as the nodular type in Korea, so MAL-PDT may be the main treatment for BCC in Korean patients. However, it could be used as an alternative treatment for selected nodular BCCs when it is difficult to use conventional therapy or when a serious cosmetic defect is expected.
Carcinoma, Basal Cell ; Cosmetics ; Humans ; Incidence ; Korea ; Photochemotherapy ; Triazenes

The purpose of this study was to assess the efficacy of photodynamic therapy (PDT) using erythrosine and a halogen light source to treat a biofilm formed on a machined surface titanium disk in vivo. Ten volunteers carried an acrylic appliance containing six machined surface titanium disks on the upper jaw over a period of five days. After the five days of biofilm formation period, the disks were removed. PDT using 20 microM erythrosine and halogen light was then applied to the biofilms formed on the disks. Experimental samples were divided into a negative control group (no erythrosine and no irradiation), E0 group (erythrosine 60s + no irradiation), E30 group (erythrosine 60s + halogen light 30s), and E60 group (erythrosine 60s + halogen light 60s). Following PDT, the bacteria in the biofilm were found to be detached from each disk. Each suspension with detached bacteria were diluted and cultivated on a blood-agar plate for five days under anaerobic conditions. The cultivated bacterial counts in the E60 group were significantly lower than the control group (86.4%) or E0 group (76.7%). In the experimental groups also, the light exposure time and bacterial counts showed a negative correlation. In conclusion, PDT using erythrosine and halogen light has bactericidal effects on biofilms formed on a titanium disk in vivo. Notably, applying 20 microM erythrosine and 60 seconds of halogen light irradiation had a significantly potent effect.
Bacteria ; Bacterial Load ; Biofilms ; Erythrosine ; Jaw ; Light ; Photochemotherapy ; Titanium ; Triazenes

BACKGROUND: Recently, photodynamic therapy (PDT) has been shown to be an effective first-line treatment for actinic keratosis (AK). However, a major limitation of PDT is the long incubation time required to allow penetration of the photosensitizer. OBJECTIVE: The aim of this study was to assess if pretreatment with an ablative carbon dioxide (CO2) fractional laser can reduce the incubation time of the photosensitizer. METHODS: Initially, 29 patients with a total of 34 AK lesions were treated with an ablative CO2 fractional laser at Ajou University Hospital between January and December 2010. Immediately after the laser treatment, topical 20% 5-aminolevulinic acid or methyl-aminolevulinate was applied to the AK lesions and incubated for 70 to 90 minutes. Then, the treated areas were illuminated with a red light source. Improvement was clinically or histologically assessed eight weeks after the treatment. RESULTS: In spite of the short incubation time, 24 lesions (70.6%) showed a complete response (CR) within three sessions of PDT (10 lesions a clinical CR and 14 lesions a clinical/histological CR). There were no significant side effects associated with the combination of ablative CO2 fractional laser and PDT. CONCLUSION: Ablative CO2 fractional laser may be considered an additional treatment option for reducing the incubation time of the photosensitizer in PDT.
Actins* ; Carbon Dioxide* ; Carbon* ; Humans ; Keratosis, Actinic* ; Lasers, Gas ; Photochemotherapy* ; Triazenes

BACKGROUND: Topical photodynamic therapy (PDT) has been increasingly used to treat malignant skin tumors including the Bowen disease. However, patients could be displeased with the long incubation time required for conventional PDT. OBJECTIVE: We evaluated the efficacy and safety of PDT with a short incubation time of ablative CO2 fractional laser pretreatment for treating Bowen disease. METHODS: Ten patients were included. Just before applying the topical photosensitizer, all lesions were treated with ablative CO2 fractional laser, following the application of methyl aminolevulinate and irradiation with red light (Aktilite CL 128). Histological confirmation, rebiopsy, and clinical assessments were performed. Adverse events were also recorded. RESULTS: Five of the ten (50%) lesions showed a complete response (CR) within three PDT sessions. After four treatment sessions, all lesions except one penile shaft lesion (90%) achieved clinical and histological CR or clinical CR only. The average number of treatments to CR was 3.70+/-1.70. The treatments showed favorable cosmetic outcomes and no serious adverse events. CONCLUSION: The results suggest that pretreatment with an ablative fractional CO2 laser before PDT has similar treatment efficacy and requires a shorter photosensitizer incubation time compared with the conventional PDT method.
Bowen's Disease ; Carbon ; Carbon Dioxide ; Cosmetics ; Humans ; Lasers, Gas ; Light ; Photochemotherapy ; Skin ; Treatment Outcome ; Triazenes

BACKGROUND: Topical photodynamic therapy (PDT) has been increasingly used to treat malignant skin tumors including the Bowen disease. However, patients could be displeased with the long incubation time required for conventional PDT. OBJECTIVE: We evaluated the efficacy and safety of PDT with a short incubation time of ablative CO2 fractional laser pretreatment for treating Bowen disease. METHODS: Ten patients were included. Just before applying the topical photosensitizer, all lesions were treated with ablative CO2 fractional laser, following the application of methyl aminolevulinate and irradiation with red light (Aktilite CL 128). Histological confirmation, rebiopsy, and clinical assessments were performed. Adverse events were also recorded. RESULTS: Five of the ten (50%) lesions showed a complete response (CR) within three PDT sessions. After four treatment sessions, all lesions except one penile shaft lesion (90%) achieved clinical and histological CR or clinical CR only. The average number of treatments to CR was 3.70+/-1.70. The treatments showed favorable cosmetic outcomes and no serious adverse events. CONCLUSION: The results suggest that pretreatment with an ablative fractional CO2 laser before PDT has similar treatment efficacy and requires a shorter photosensitizer incubation time compared with the conventional PDT method.
Bowen's Disease ; Carbon ; Carbon Dioxide ; Cosmetics ; Humans ; Lasers, Gas ; Light ; Photochemotherapy ; Skin ; Treatment Outcome ; Triazenes