Photodynamic Therapy in Spinal Metastases: A Qualitative Analysis of Published Results

Abstract

The current study was to perform qualitative comparison of photodynamic therapy (PDT), based on previously published articles on spinal disease distribution status before and after treatment. Spinal metastasis, the migration of primary cancer cells and establishment of secondary tumors in the spine. We electronically searched CENTRAL (The Cochrane Library 2012), MEDLINE, EMBASE, CINAHL and AMED (from their beginning to December 31, 2012) to identify published studies assessing the effectiveness of PDT in spinal metastases. Our inclusion criteria resulted in only 4 articles, all in mice models. Due to study limitations and sparse data, the quality of evidence for all outcomes was low. Our analyses shows that effects on stereological and mechanical properties observed at the 1-week time point post-PDT are maintained at a longer 6-week time point, with combined PDT þ bisphosphonate treatment being the most beneficial in terms of bone enhancement. Additionally, the combination of PDT þ radiation therapy also demonstrated significant increases in stereological parameters, suggesting that previous radiation therapy treatment does not preclude the boneenhancing effects of PDT and in fact may be synergistic in the longer term. The boneenhancing effects of PDT in combination with conventional treatments, and its ability to destroy metastatic human breast cancer cells within bone, present PDT as an attractive novel treatment for spinal metastasis. The positive results from these preclinical studies might motivate future clinical translation of PDT for spinal metastasis.

Interstitial Photodynamic Therapy—A Focused Review

“…In addition, recent preclinical and clinical data suggest that PDT may have a role as an adjunct in cancer therapy [ 2 , 3 , 51 , 52 , 53 ]. Moreover, prior radiation therapy does not preclude the use of PDT to control malignant disease [ 54 ]. Thus, PDT and, in particular, I-PDT may be used as an additional therapy that has the potential to improve outcomes in patients with refractory or locally-advanced cancer who need better treatment options.…”

Photodynamic therapy for solid tumors: A review of the literature

“…In some in vitro and in vivo studies, PDT has been combined with radiation, chemotherapy, immune‐modulating agents, and receptor‐targeted agents, with synergistic effects . Animal models suggest that PDT may be effective for spinal metastases . A Phase I/IIa clinical trial for PDT in primary breast cancer was completed in 2017, though no study results have yet been posted .…”

“…70,71 Animal models suggest that PDT may be effective for spinal metastases. 72 A Phase I/IIa clinical trial for PDT in primary breast cancer was completed in 2017, though no study results have yet been posted. 73 A Phase II trial for the efficacy of CLIPT for cutaneous metastases of breast cancer with no other available therapy options is currently underway.…”

Progress of Phototherapy Applications in the Treatment of Bone Cancer

“…In addition, the clinical application of PDT for musculoskeletal cancers is often combined with radiotherapy [ 177 ]. Synovial sarcoma is one of the most common malignant soft-tissue tumors encountered in children and adolescents with high recurrence rate (~80%) after resection.…”