Combination of Fluorescence-Guided Surgery With Photodynamic Therapy for the Treatment of Cancer

Abstract

Specific visualization of body parts is needed during surgery. Fluorescence-guided surgery (FGS) uses a fluorescence contrast agent for in vivo tumor imaging to detect and identify both malignant and normal tissues. There are several advantages and clinical benefits of FGS over other conventional medical imaging modalities, such as its safety, effectiveness, and suitability for real-time imaging in the operating room. Recent advancements in contrast agents and intraoperative fluorescence imaging devices have led to a greater potential for intraoperative fluorescence imaging in clinical applications. Photodynamic therapy (PDT) is an alternative modality to treat tumors, which uses a light-sensitive drug (photosensitizers) and special light to destroy the targeted tissues. In this review, we discuss the fluorescent contrast agents, some newly developed imaging devices, and the successful clinical application of FGS. Additionally, we present the combined strategy of FGS with PDT to further improve the therapeutic effect for patients with cancer. Taken together, this review provides a unique perspective and summarization of FGS.

Exploiting the Cellular Redox‐Control System for Activatable Photodynamic Therapy

“…It employs a small‐molecule photosensitiser (PS), light and endogenous molecular oxygen to produce cytotoxic reactive oxygen species (ROS) . Depending on the intracellular localisation of the PS (i.e., where the ROS is produced), PDT‐induced cancer cell death can occur through apoptotic or necrotic pathways, in addition to causing vasculature disruption in solid tumours, local inflammation and eliciting an immune response . An advantage of PDT over traditional cancer therapies such as chemotherapy and radiotherapy is that it is relatively mild as it requires low‐energy (visible) light to produce ROS for the destruction of tumours.…”

“…An advantage of PDT over traditional cancer therapies such as chemotherapy and radiotherapy is that it is relatively mild as it requires low‐energy (visible) light to produce ROS for the destruction of tumours. Additionally, the PSs are inherently fluorescent, which has made them useful for diagnostic imaging and real‐time fluorescence‐guided surgery …”

Recent Advances in Nanotheranostics for Treat‐to‐Target of Rheumatoid Arthritis

“…Research shows near‐infrared (NIR) light can efficiently penetrate inflamed joints affected by RA, thus phototherapy based on nanomaterials may provide new opportunities for the treatment of RA 119. In PDT, photosensitizers generate ROS such as singlet oxygen ( 1 O 2 ), superoxide, hydrogen peroxide, and hydroxyl radical under light stimulation to kill cancer or inflammatory cells 120–122. In parallel, the photothermal conversion agents covert NIR light into localized heat for destroying disease regions 123,124.…”

“…[119] In PDT, photosensitizers generate ROS such as singlet oxygen ( 1 O 2 ), superoxide, hydrogen peroxide, and hydroxyl radical under light stimulation to kill cancer or inflammatory cells. [120][121][122] In parallel, the photothermal conversion agents covert NIR light into localized heat for destroying disease regions. [123,124] For RA treatment, NIR light with particular penetration depth can penetrate the inflamed joints, ensuring the treatment effect of nanomaterials in PDT and PTT.…”

Colon cancer – new strategies of treatment

“…In addition, researchers also studied the usefulness of PDT as a complementary method conducted intraoperatively in order to visualise the pathological tissue masses more precisely thanks to accumulation of the photosensitiser in the cancer tissue, which -upon its exposure to the activity of light with a particular wave length -becomes clearly separated from the healthy tissue. In this way, higher completeness of the procedure was achieved [52]. In recent years, research has been targeted at using the immunomodulating effect of PDT in combination with modern immunotherapy as a personalised and targeted punktów uchwytu podczas opracowywania nowych, celowanych, skuteczniejszych metod leczenia.…”