Adjuvant photodynamic therapy in head and neck cancer after tumor‐positive resection margins

Doeveren, T.E.M. van; Karakullukçu, Barış; Veen, R.L.P. van; López-Yurda, Marta; Schreuder, Willem H.; Tan, I. Bing

doi:10.1002/lary.26792

Cited by 31 publications

(30 citation statements)

References 30 publications

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“…the tissue vascular perfusion) and to have as little extravascular blood as possible in the cavity during the illumination. Besides, to minimize a surgical stress response resulting in increased cytokine release which might negatively influence the PDT effect . Extravascular blood shields the therapeutic light from entering the tissue and is therefore expected to compromise the PDT effect.…”

Section: Discussionmentioning

confidence: 99%

“…Chemotherapy in these patients is not curative. Intracavity PDT demonstrated to be a feasible adjuvant therapy after surgical debulking to achieve local tumor control without the severe adverse effects associated with aforementioned conventional treatment options . However, achieving a reproducible and controlled dosimetric approach remained cumbersome.…”

Section: Introductionmentioning

confidence: 99%

“…The source was manually positioned and manually kept at this location, verified under endoscopic guidance. The fluence rate at the target area was monitored using multiple isotropic detectors connected to a dosimetry device . The laser was then activated and the illumination lasted until a cumulative light dose of 20 J·cm −2 was measured.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

On the Development of a Light Dosimetry Planning Tool for Photodynamic Therapy in Arbitrary Shaped Cavities: Initial Results

Doeveren

Bouwmans

Wassenaar

et al. 2020

Photochem & Photobiology

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Previous dosimetric studies during photodynamic therapy (PDT) of superficial lesions within a cavity such as the nasopharynx, demonstrated significant intra‐ and interpatient variations in fluence rate build‐up as a result of tissue surface re‐emitted and reflected photons, which depends on the optical properties. This scattering effect affects the response to PDT. Recently, a meta‐tetra(hydroxyphenyl)chlorin‐mediated PDT study of malignancies in the paranasal sinuses after salvage surgery was initiated. These geometries are complex in shape, with spatially varying optical properties. Therefore, preplanning and in vivo dosimetry is required to ensure an effective fluence delivered to the tumor. For this purpose, two 3D light distribution models were developed: first, a simple empirical model that directly calculates the fluence rate at the cavity surface using a simple linear function that includes the scatter contribution as function of the light source to surface distance. And second, an analytical model based on Lambert’s cosine law assuming a global diffuse reflectance constant. The models were evaluated by means of three 3D printed optical phantoms and one porcine tissue phantom. Predictive fluence rate distributions of both models are within ± 20% accurate and have the potential to determine the optimal source location and light source output power settings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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On the Development of a Light Dosimetry Planning Tool for Photodynamic Therapy in Arbitrary Shaped Cavities: Initial Results

Doeveren

Bouwmans

Wassenaar

et al. 2020

Photochem & Photobiology

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“…Hence, our findings are not directly relevant to patients with substantive mechanical instability (i.e., a SINS score of greater than 12) who would require a more conventional open surgical procedure such as neurologic decompression with associated multilevel instrumented vertebral reconstruction. PDT potentially could also be a useful adjuvant in this open surgical setting as it has been demonstrated in other surgical sites; however, this would require further study (49)(50)(51).…”

Section: Discussionmentioning

confidence: 99%

Photodynamic Therapy for the Treatment of Vertebral Metastases: A Phase I Clinical Trial

Fisher

Ali

Detsky

et al. 2019

Clinical Cancer Research

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Purpose: Vertebroplasty (VP) and balloon kyphoplasty (KP) are minimally invasive stabilization procedures for pathologic vertebral compression fractures (VCF). Concurrent administration of photodynamic therapy (PDT) as a tumor-ablative modality has yet to be studied in humans as a potential complement to improved mechanical stability that is afforded by vertebral cement augmentation (VCA). Patients and Methods: This first-inhuman trial used a single 6 mg/m 2 dose of the clinical photosensitizer Visudyne with escalating laser light doses. Following a cohort of lightonly controls (n ¼ 6), the drug and light treatment groups (n ¼ 6 each) were 50, 100, 150, and 200 J/cm. VCA was performed within 15 minutes following PDT. Patients were clinically reviewed at 1 and 6 weeks. The primary outcome measure was safety from a neurologic perspective. Results: Thirty patients comprising a variety of primary tumors were treated with PDT and either KP or VP. Vertebral PDT was technically feasible and delivered in all study patients. No dose groups showed significant increases in pain as defined by the generic SF-36 as well as disease-specific EORTC-QLQ-BM22 and EORTC-QLQ-C15-PAL questionnaires. The 50 and 100 J/cm groups showed the most significant pain reduction (P < 0.05). Twelve (40%) patients experienced complications during the study including 3 patients with further vertebral fracture progression by 6 weeks despite VCA. No complications were directly attributed to PDT. Conclusions: Using the parameters described, vertebral PDT as an adjunct to VCA is safe from a pharmaceutical and neurologic perspective. The results of this trial motivate scaleup study evaluating potential PDT efficacy in vertebral metastatic treatment.

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“…The report of Cengel et al (1) forms part of a growing body of work not only using PDT as an adjuvant to surgery (29)(30)(31)(32)(33)(34)(35)(36)(37)(38), but also in advancing explicit PDT dosimetry (39,40). Their work stands as an important contribution in assessing tissue optical properties and oxygenation, and sensitizer effects in the peritoneal cavity.…”

Section: A Deeper Tissue Pdt Effectmentioning

confidence: 99%

In vivo Tissue Evaluation Reveals Improvements in Explicit PDT Dosimetry

Greer

2020

Photochem & Photobiology

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Adjuvant photodynamic therapy in head and neck cancer after tumor‐positive resection margins

Abstract: 4. Laryngoscope, 128:657-663, 2018.

Cited by 31 publications

References 30 publications

On the Development of a Light Dosimetry Planning Tool for Photodynamic Therapy in Arbitrary Shaped Cavities: Initial Results

On the Development of a Light Dosimetry Planning Tool for Photodynamic Therapy in Arbitrary Shaped Cavities: Initial Results

Photodynamic Therapy for the Treatment of Vertebral Metastases: A Phase I Clinical Trial

In vivo Tissue Evaluation Reveals Improvements in Explicit PDT Dosimetry

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