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Tomaselli, F; Maier, A; Pinter, H; Stranzl, H; Smolle-Jüttner, FM.
Photodynamic therapy enhanced by hyperbaric oxygen in acute endoluminal palliation of malignant bronchial stenosis (clinical pilot study in 40 patients).
Eur J Cardiothorac Surg. 2001; 19(5):549-554 Doi: 10.1016/S1010-7940(01)00635-2 [OPEN ACCESS]
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Co-authors Med Uni Graz: Maier Alfred; Pinter Hans; Smolle-Juettner Freyja-Maria; Stranzl-Lawatsch Heidi
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Abstract:: Objectives: Photodynamic tumor therapy (PDT) is based upon a photochemical reaction that is limited by the availability of molecular oxygen in the target tissue. The use of hyperbaric oxygenation (HBO) increases the amount of oxygen available for the process may thereby enhance the efficacy of PDT. We proved in a prospective, non-randomized clinical pilot study the acute effects on malignant bronchial stenosis and the technical feasibility of combined PDT/HBO. Methods: Forty patients (29 males, 11 females, mean age: 64.3 years range 39-82 years) with inoperable, advanced malignant bronchial tumor stenosis were studied prospectively. Photosensitization was carried out using a hematoporphyrin-derivative 2 mg/kg bw 48 h prior to PDT. The light dose was calculated as 300 J/cm fiber tip. The assessment of outcome 1 and 4 weeks after PDT/HBO was done by endoscopy, chest X-ray, spirometry, laboratory parameters, subjective report of dyspnea and Karnofsky performance status. Results: At 1 and 4 weeks after the treatment the patients felt a significant improvement of dyspnea and hemoptysis alongside with an objective subsiding of poststenotic pneumonia, though spirometric parameters revealed no significant difference. A significant reduction of tumor stenosis (P < 0.05) and an improvement of the Karnofsky performance status (P < 0.05) were documented 1 and 4 weeks after PDT/HBO. No therapy related complications were observed. Conclusion: Although the small number of patients does not allow to draw definitive conclusions, the results suggest that combined PDT/HBO represents a new, safe and technically feasible approach. It enables efficient and rapid reduction of the endoluminal tumor load and helps conditioning the patient for further treatment procedures. (C) 2001 Elsevier Science B.V. All rights reserved.
Find related publications in this database (using NLM MeSH Indexing): Adenocarcinoma - complications Adenocarcinoma - pathology Adenocarcinoma - therapy; Adult -; Aged -; Aged, 80 and over -; Bronchial Diseases - etiology Bronchial Diseases - therapy; Bronchial Neoplasms - complications Bronchial Neoplasms - drug therapy Bronchial Neoplasms - pathology Bronchial Neoplasms - therapy; Carcinoma, Large Cell - complications Carcinoma, Large Cell - pathology Carcinoma, Large Cell - therapy; Carcinoma, Squamous Cell - complications Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - therapy; Constriction, Pathologic -; Female -; Humans -; Hyperbaric Oxygenation -; Male -; Middle Aged -; Palliative Care -; Photochemotherapy -; Pilot Projects -; Prospective Studies -
Find related publications in this database (Keywords): photodynamic therapy; hyperbaric oxygenation; malignant bronchial stenosis