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Effect of N‐acetylcysteïne on photofrin‐induced skin photosensitivity in patients
Author(s) -
Baas Paul,
van Mansom Inge,
van Tinteren Harm,
Stewart Fiona A.,
van Zandwijk Nico
Publication year - 1995
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/lsm.1900160407
Subject(s) - photosensitivity , photodynamic therapy , singlet oxygen , medicine , edema , skin cancer , chemistry , cancer , dermatology , surgery , oxygen , materials science , optoelectronics , organic chemistry
Background and Objective: One of the major side effects of photodynamic therapy (PDT) employing Photofrin as the sensitizer is enhanced photosensitivity of the skin. The basic mechanism in PDT damage is believed to be the formation of singlet oxygen and radical species. N‐acetylcysteïne (NAC) increases glutathione levels and is known to prevent pathology elicited by radicals and reactive species. Study Design/Materials and Methods: NAC was tested in a randomized, open label study for its protective effect on skin photosensitivity. Twenty‐seven patients treated with PDT for central obstructive lung cancer or esophageal cancer received either “early” or “delayed” NAC, starting 5 or 10 days after Photofrin, in a dose of 3 × 600 mg per day for 5 days. Light, obtained from a halogen lamp (fluence rate 200 mW·cm −2 ) was used to illuminate skin patches of 2.5 cm 2 on the back (10, 25, and 50 J·cm −2 ). Skin response was measured by using a visual scoring system and by measuring the redness using a reflectance meter. Results: Skin responses varied from no changes at 10 J·cm −2 to redness with edema at energies of 50 J·cm −2 . In the absence of edema, measurements with the reflectance meter appeared to be more sensitive than visual scoring. Conclusion: In a limited number of patients, there was a trend for decreased sensitivity after NAC, but statistical analysis failed to show any significant protective effect of this short course of NAC. © 1995 Wiley‐Liss, Inc.