Does Hyperbaric Oxygen Enhance the Effect of  Photodynamic Therapy in Patients with Advanced Esophageal  Carcinoma? A Clinical Pilot Study

Maier, Andrea B.; Anegg, Udo; Tomaselli, Florian; Rehak, Peter; Sankin, Oliver; Fell, B.; Renner, Heiko; Pintér, H; Smolle‐Jüttner, Freyja Maria; Friehs, G

doi:10.1055/s-2000-132

Cited by 33 publications

(24 citation statements)

References 11 publications

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“…In photodynamic therapy, molecular oxygen is a crucial factor for hematoporphyrin‐derivative photodynamic activity in vitro (4,16). By absorption of light, photosensitizers are excited to an energetic state and indirectly react with molecular oxygen.…”

Section: Discussionmentioning

confidence: 99%

Hyperoxygenation Enhances the Tumor Cell Killing of Photofrin-mediated Photodynamic Therapy¶

Huang

Chen

Shakil

et al. 2007

Photochemistry and Photobiology

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Tumor hypoxia, either preexisting or as a result of oxygen depletion during photodynamic therapy (PDT) light irradiation, can significantly reduce the effectiveness of PDT‐induced cell killing. To overcome tumor hypoxia and improve tumor cell killing, we propose using supplemental hyperoxygenation during Photofrin‐PDT. The mechanism for the tumor cure enhancement of the hyperoxygenation–PDT combination is investigated using an in vivo–in vitro technique. A hypoxic tumor model was established by implanting mammary adenocarcinoma in the hind legs of mice. Light irradiation (200 J/cm2 at either 75 or 150 mW/cm2), under various oxygen supplemental conditions (room air, carbogen, 100% normobaric or hyperbaric oxygen), was delivered to animals that received 12.5 mg/kg Photofrin 24 h before light irradiation. Tumors were harvested at various time points after PDT and grown in vitro for colony formation analysis. Treated tumors were also analyzed histologically. The results show that when PDT is combined with hyperoxygenation, the hypoxic condition could be improved and the cell killing rate at various time points after PDT could be significantly enhanced over that without hyperoxygenation, suggesting an enhanced direct and indirect cell killing associated with high‐concentration oxygen breathing. This study further confirms our earlier observation that when a PDT treatment is combined with hyperoxygenation it can be more effective in controlling hypoxic tumors.

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Section: Discussionmentioning

confidence: 99%

Hyperoxygenation Enhances the Tumor Cell Killing of Photofrin-mediated Photodynamic Therapy¶

Huang

Chen

Shakil

et al. 2007

Photochemistry and Photobiology

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“…According to recent literature, several experimental studies have confirmed the positive effect of PDT combined with HBO, which may help to enhance the therapeutical effect of PDT in case of advanced esophageal cancer, cancer of the GEJ and in patients with malignant tracheo-bronchial stenosis suffering from progressive lung cancer [6,7,[37][38][39]. By the help of supportive HBO, satisfactory reduction of the endoluminal tumor load can be achieved and it helps conditioning the patient for further palliative treatment procedures.…”

Section: Discussionmentioning

confidence: 92%

“…According to those animal-based studies, experimental clinical pilot studies in human patients suffering from different thoracic malignancies were conducted [6,7,16,[37][38][39]. Those promising results suggested that HBO in PDT might accelerate the photodynamic reaction by raising the transmission efficiency of light energy, increasing the quantum amount of oxygen.…”

Section: Discussionmentioning

confidence: 99%

“…Due to this fact, a new approach consisting of PDT under hyperbaric oxygenation (HBO) under 2 ATA (atmosphere absolutes) performed in a hyperbaric chamber was experimentally considered in order to achieve an enhancement of the effect of PDT. Several pilot studies investigating the therapeutic benefit of PDT under HBO in comparison to PDT under normo-baric conditions were carried out at our department and published in literature [6,7,16,[37][38][39].…”

Section: Methodsmentioning

confidence: 99%

“…Several reports and clinical pilot studies of successful esophageal PDT -even conducted at our department -are documented in literature [25,[37][38][39][40][41][42].…”

Section: Methodsmentioning

confidence: 99%

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The clinical impact of photodynamic therapy in thoracic surgery

et al. 2010

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Zusammenfassung. Grundlagen: Die Prognose von Patienten mit malignem Pleuramesotheliom, inoperablem fortgeschrittenen Ö sophagus-oder Bronchuskarzinom ist nach wie vor sehr trist. Die photodyname Therapie (PDT) stellt eine sehr wirkungsvolle Option in der Palliativtherapie dieser Malignome dar.Methodik: Die Funktionsweise der PDT beruht auf der Illuminierung von Malignomen nach vorangegangener intravenöser Photosensibilisierung und konsekutiver selektiver Tumorzellnekrose. Im Falle des Ö sophaguskarzinoms als auch der malignen Bronchusstenose wird die PDT endoskopisch durchgefü hrt, beim malignen Pleuramesotheliom geschieht dies intraoperativ im Anschluss an die Dekortikation.Ergebnisse: Mit Hilfe der PDT wird eine signifikante Reduktion der endoluminalen bzw. intrakavitären Tumormasse, verbunden mit deutlich verbesserter Lebensqualität und verlängertem rezidiv-freiem Intervall, erreicht. Außerdem kann der Patient dadurch fü r weitere palliative Therapiemaßnahmen konditioniert werden.Schlussfolgerungen: Die PDT stellt eine sichere, gut durchfü hrbare und äußerst wirksame Option in der endoskopischen Palliativtherapie des fortgeschrittenen Ö sophagus-als auch des Bronchuskarzinoms dar. Ü berdies kann die PDT als supportive Maßnahme in der chirurgischen Therapie des malignen Pleuramesothelioms eingesetzt werden.Schlüsselwörter: Ö sophaguskarzinom, Bronchuskarzinom, malignes Pleuramesotheliom, photodyname Therapie, palliative Therapie.Summary. Background: Patients suffering from malignant pleural mesothelioma, advanced esophageal cancer or progressive lung cancer, ineligible for resection, still have a poor prognosis. Photodynamic Therapy (PDT) is a very effective approach in the palliative treatment regimen of these malignancies.Methods: The mechanism of function is based on the illumination of malignant tissue after selective accumulation of photosensitizers in tumor cells resulting in local tumor necrosis. In case of esophageal cancer and malignant bronchogenic stenosis, PDT is performed endoscopically whereas in malignant pleural mesothelioma intra-cavitary PDT is done after decortication.Results: Significant reduction of the endoluminal/ intrathoracic tumor associated with increased quality of life and prolonged disease-free survival can be achieved which helps conditioning the patient for further palliative treatment procedures.Conclusions: PDT has become a safe, feasible, and efficient approach in the endoscopic palliation of advanced esophageal cancer, malignant tracheo-bronchial stenosis as well as a supportive treatment option in the surgical management of malignant pleural mesothelioma.

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Hypoxia signaling in cancer: Implications for therapeutic interventions

Zhuang

Liu

et al. 2023

MedComm

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Hypoxia is a persistent physiological feature of many different solid tumors and a key driver of malignancy, and in recent years, it has been recognized as an important target for cancer therapy. Hypoxia occurs in the majority of solid tumors due to a poor vascular oxygen supply that is not sufficient to meet the needs of rapidly proliferating cancer cells. A hypoxic tumor microenvironment (TME) can reduce the effectiveness of other tumor therapies, such as radiotherapy, chemotherapy, and immunotherapy. In this review, we discuss the critical role of hypoxia in tumor development, including tumor metabolism, tumor immunity, and tumor angiogenesis. The treatment methods for hypoxic TME are summarized, including hypoxia‐targeted therapy and improving oxygenation by alleviating tumor hypoxia itself. Hyperoxia therapy can be used to improve tissue oxygen partial pressure and relieve tumor hypoxia. We focus on the underlying mechanisms of hyperoxia and their impact on current cancer therapies and discuss the prospects of hyperoxia therapy in cancer treatment.

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Does Hyperbaric Oxygen Enhance the Effect of Photodynamic Therapy in Patients with Advanced Esophageal Carcinoma? A Clinical Pilot Study

Abstract: Combined PDT/HBO represents a new approach in the treatment of esophageal cancer which, in this pilot study, appears to have enhanced the efficiency of PDT.

Cited by 33 publications

References 11 publications

Hyperoxygenation Enhances the Tumor Cell Killing of Photofrin-mediated Photodynamic Therapy¶

Hyperoxygenation Enhances the Tumor Cell Killing of Photofrin-mediated Photodynamic Therapy¶

The clinical impact of photodynamic therapy in thoracic surgery

Hypoxia signaling in cancer: Implications for therapeutic interventions

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