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Optimal light dose for interstitial photodynamic therapy in treatment for malignant brain tumors
Author(s) -
Krishnamurthy Satish,
Powers Stephen K.,
Witmer Peggy,
Brown Tony
Publication year - 2000
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/1096-9101(2000)27:3<224::aid-lsm4>3.0.co;2-#
Subject(s) - photodynamic therapy , medicine , chemistry , organic chemistry
Background and Objective The primary goal was to determine the maximal tolerable light dose that can be administered to patients undergoing multifiber interstitial photodynamic therapy (PDT) of malignant brain tumors at a fixed dose of photosensitizer. Study Design/Materials and Methods Eighteen patients (12 glioblastomas, 5 anaplastic astrocytoma, and 1 malignant ependymoma) were included in this study. The total light dose delivered to the tumor was divided into three groups of six patients each: 1,500–3,700 J, 3,700–4,400 J, and 4,400–5,900 J. Results Five patients (all glioblastomas) demonstrated postoperative permanent neurologic deficits. None of the patients in 1,500–3,700 J, two patients in 3,700–4,400 J, and three patients in 4,400–5,900 J had neurologic deficits. Glioblastomas recurred more often than anaplastic astrocytomas. Increasing the light dose did not make a difference in local/regional control of glioblastomas. Patients with anaplastic astrocytomas survived (mean, 493 days) longer than patients with glioblastomas (mean, 116.5 days) after PDT. Four patients had prolonged survival (more than a year) after PDT. Conclusions Increasing the total light dose delivered to the tumor increases the odds of having a permanent neurologic deficit but does not increase survival or time to tumor progression. There was no difference in local or marginal recurrence with increasing light dose. Recurrent anaplastic astrocytomas tend to do better than recurrent glioblastomas with PDT. Lasers Surg. Med. 27:224–234, 2000. © 2000 Wiley‐Liss, Inc.