Application of intraoperative photodynamic therapy in patients suspected of recurrence post radical surgery: A single center experience

Photodiagnosis Photodyn Ther. 2022 Dec:40:103047. doi: 10.1016/j.pdpdt.2022.103047. Epub 2022 Aug 2.

Abstract

Background: Difficult to resect tumors may be treated with a combination of radical surgery and photodynamic therapy to try to reduce recurrence. The aim of this single center study is to present results from a combined application of radical surgery with intraoperative PDT for patients with various cancers suspected of high risk for post-operative local recurrence.

Methods: Radical surgery combined with intraoperative PDT was performed in each and every patient under study at different time points from June 2020 to July 2021, and the PDT irradiation time ranged from 10, 20, 25 and 30 min. Hematoporphyrin, as a photo synthesizer, was administered intravenously 48 h before surgery and during the operative period respectively, at a 3 mg/kg dose. In addition, the mean and median survival times for each of these patients were also evaluated. Patient's overall disease-Free Survival (DFS) and survival (OS) were immensely evaluated.

Results: 12 patients (33.3% female and 66.7 % male) underwent radical surgery and PDT simultaneously. No photosensitivity events were reported in the included patients, except for one case with a moderate to severe erythema. Intraoperative PDT was tolerated in all included patients without serious liver and kidney damages. As from the time these patients underwent radical surgery and PDT, three mortalities were recorded and the remaining 9 patients had some remarkable outcomes with less or no recurrences.

Conclusions: Intraoperative PDT is a potentially safe therapeutic strategy for various tumor patients who undergo operation. Intraoperative PDT combined with surgery may improve local tumor control but this needs to be tested in a larger patient population.

Keywords: Intra-operative photodynamic therapy (PDT); Oncology patients; Prognostic effects; Radical surgery; Recurrence; Simultaneously.

MeSH terms

  • Disease-Free Survival
  • Female
  • Humans
  • Male
  • Photochemotherapy* / methods
  • Treatment Outcome