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Elevated Serum Cytokine Levels in Mesothelioma Patients Who Have Undergone Pleurectomy or Extrapleural Pneumonectomy and Adjuvant Intraoperative Photodynamic Therapy ¶
Author(s) -
Yom Sue S.,
Busch Theresa M.,
Friedberg Joseph S.,
Wileyto E. Paul,
Smith Deborah,
Glatstein Eli,
Hahn Stephen M.
Publication year - 2003
Publication title -
photochemistry and photobiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.818
H-Index - 131
eISSN - 1751-1097
pISSN - 0031-8655
DOI - 10.1562/0031-8655(2003)0780075esclim2.0.co2
Subject(s) - medicine , pleurectomy , photodynamic therapy , cytokine , surgery , extrapleural pneumonectomy , mesothelioma , gastroenterology , pneumonectomy , pathology , lung , chemistry , peritoneal mesothelioma , organic chemistry
Patients treated on a Phase‐I clinical trial of photodynamic therapy (PDT) developed a systemic capillary leak syndrome that constituted the dose‐limiting toxicity. We examined serum samples from patients treated at the maximally tolerated dose level for evidence of a systemic, cytokine‐mediated inflammatory response. Patients underwent pleurectomy or extrapleural pneumonectomy (EPP) followed by intraoperative PDT of the thorax using Foscan® at a dose of 0.1 mg/kg 6 days before surgery and 652 nm red light at a dose of 10 J/cm 2 . Levels of interferon‐γ (IFN‐γ), tumor necrosis factor–α (TNF‐α), interleukin (IL)‐1β, IL‐6, IL‐8, IL‐10 and IL‐12 were assayed before Foscan® administration; after anesthetic induction, surgical resection and light delivery; in postoperative recovery and the day after the surgery. Of the analyzed patients, eight underwent a pleurectomy and one an EPP followed by PDT. IFN‐γ, TNF‐α and IL‐12 showed no elevation, but IL‐1β, IL‐6, IL‐8 and IL‐10 levels were elevated after surgery and PDT. IL‐1β showed a statistically significant variation from baseline after surgery and IL‐6, after PDT. The results suggest a systemically mediated inflammatory response resulting from thoracic surgery followed by PDT. Further investigation of specific mechanisms is warranted.