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Maier, A; Tomaselli, F; Matzi, V; Rehak, P; Pinter, H; Smolle-Jüttner, FM.
Photosensitization with hematoporphyrin derivative compared to 5-aminolaevulinic acid for photodynamic therapy of esophageal carcinoma.
Ann Thorac Surg. 2001; 72(4):1136-1140 Doi: 10.1016/S0003-4975(01)03031-4
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Leading authors Med Uni Graz: Maier Alfred
Co-authors Med Uni Graz: Matzi Veronika; Pinter Hans; Rehak Peter; Smolle-Juettner Freyja-Maria
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Abstract:: Background. Hematoporphyrin derivatives (HpD) as sensitizers for photodynamic therapy (PDT) in advanced esophageal cancer carry the risk of prolonged photosensitivity of the skin. New sensitizers such as 5-aminolae-vulinic acid (ALA) with low rates of skin phototoxicity appear to be promising alternatives. The aim of this study was to evaluate the efficacy of ALA compared with HpD for PDT in advanced esophageal carcinoma regarding phototoxicity of the skin, reduction of dysphagia, tumor stenosis and length, and Karnovsky performance status.Methods. After diagnostic workup, photosensitization was done in 22 patients with ALA (60 mg/kg body weight, oral, 6 to 8 hours before PDT) and in 27 patients with a hematoporphyrin derivative (2 mg/kg body weight, intravenously, 48 hours before PDT). The light dose was calculated as 300 J/cm fiber tip. Light at 630 run was applied using a pumped dye laser. In both groups, additional hyperbaric oxygenation was applied at a level of 2 absolute atmospheric pressure.Results. Improvement regarding dysphagia, stenosis diameter, and tumor length could be obtained in both treatment arms with a significant difference in favor of the HpD group (p = 0.02, p = 0.0000; and p = 0.000014, respectively). A questionnaire of patients in the Hpl) group confirmed that the ability of swallowing a meal was superior compared with the discomfort from limitation to sun exposure. No sunburn or other major treatment-related complication occurred in both treatment arms.Conclusions. Despite the limitations of a nonrandomized study, photosensitzation with Hpl) seems to be more effective in PDT of advanced esophageal carcinoma compared with ALA. (C) 2001 by The Society of Thoracic Surgeons.
Find related publications in this database (using NLM MeSH Indexing): Adenocarcinoma - drug therapy Adenocarcinoma - pathology; Aged -; Aged, 80 and over -; Aminolevulinic Acid - therapeutic use; Carcinoma, Squamous Cell - drug therapy Carcinoma, Squamous Cell - pathology; Esophageal Neoplasms - drug therapy Esophageal Neoplasms - pathology; Esophagus - drug effects Esophagus - pathology; Female -; Follow-Up Studies -; Hematoporphyrin Derivative - adverse effects Hematoporphyrin Derivative - therapeutic use; Hematoporphyrin Photoradiation -; Humans -; Male -; Middle Aged -; Neoplasm Staging -; Treatment Outcome -