RSS-Feed abonnieren
DOI: 10.1055/s-0034-1392150
Initial human experience of endoscopic ultrasound-guided photodynamic therapy with a novel photosensitizer and a flexible laser-light catheter
Publikationsverlauf
submitted29. Oktober 2014
accepted after revision31. März 2015
Publikationsdatum:
12. Juni 2015 (online)
![](https://www.thieme-connect.de/media/endoscopy/201511/lookinside/thumbnails/11554_10-1055-s-0034-1392150-1.jpg)
Background and study aims: New methods for the endoscopic selective ablation of locally advanced pancreaticobiliary malignancies as a minimally invasive approach are needed. Our aim was to examine the feasibility and safety of endoscopic ultrasonography (EUS)-guided photodynamic therapy (PDT) for local tumor control in patients with locally advanced pancreaticobiliary malignancies.
Patients and methods: A chlorin e6 derivative and a flexible laser-light catheter were used to perform EUS-guided PDT in four patients with locally advanced pancreaticobiliary malignancies.
Results: EUS-guided PDT was technically feasible in all four patients with locally advanced pancreaticobiliary malignancies (two in the caudate lobe of the liver, one in the far distal bile duct, and one in the tail of the pancreas). No treatment-related complications occurred. The median volume of necrosis produced by PDT was 4.0 cm3 (range 0.7 – 11.3). Disease remained stable in all four patients during a median follow-up of 5 months (range 3 – 7).
Conclusion: These preliminary data suggest that EUS-guided PDT with a second-generation photosensitizer and a flexible laser probe is feasible and safe.
* Jun-Ho Choi and Dongwook Oh contributed equally to this article.
-
References
- 1 Halfdanarson TR, Haraldsdottir S, Borad MJ. Advances in systemic therapy for advanced pancreatobiliary malignancies. F1000Res 2013; 2: 105
- 2 Park do H, Lee SS, Park SE et al. Randomised phase II trial of photodynamic therapy plus oral fluoropyrimidine, S-1, versus photodynamic therapy alone for unresectable hilar cholangiocarcinoma. Eur J Cancer 2014; 50: 1259-1268
- 3 Ji W, Yoo JW, Bae EK et al. The effect of Radachlorin(R) PDT in advanced NSCLC: a pilot study. Photodiagnosis Photodyn Ther 2013; 10: 120-126
- 4 Istomin YP, Lapzevich TP, Chalau VN et al. Photodynamic therapy of cervical intraepithelial neoplasia grades II and III with Photolon. Photodiagnosis Photodyn Ther 2010; 7: 144-151
- 5 Copley L, van der Watt P, Wirtz KW et al. Photolon, a chlorin e6 derivative, triggers ROS production and light-dependent cell death via necrosis. Int J Biochem Cell Biol 2008; 40: 227-235
- 6 Kasuya K, Shimazu M, Suzuki M et al. Novel photodynamic therapy against biliary tract carcinoma using mono-L: -aspartyl chlorine e6: basic evaluation for its feasibility and efficacy. J Hepatobiliary Pancreat Sci 2010; 17: 313-321
- 7 Pietruska M, Sobaniec S, Bernaczyk P et al. Clinical evaluation of photodynamic therapy efficacy in the treatment of oral leukoplakia. Photodiagnosis Photodyn Ther 2014; 11: 34-40
- 8 Chan HH, Nishioka NS, Mino M et al. EUS-guided photodynamic therapy of the pancreas: a pilot study. Gastrointest Endosc 2004; 59: 95-99
- 9 Yusuf TE, Matthes K, Brugge WR. EUS-guided photodynamic therapy with verteporfin for ablation of normal pancreatic tissue: a pilot study in a porcine model (with video). Gastrointest Endosc 2008; 67: 957-961
- 10 Ayaru L, Wittmann J, Macrobert AJ et al. Photodynamic therapy using verteporfin photosensitization in the pancreas and surrounding tissues in the Syrian golden hamster. Pancreatology 2007; 7: 20-27
- 11 Konda VJ, Aslanian HR, Wallace MB et al. First assessment of needle-based confocal laser endomicroscopy during EUS-FNA procedures of the pancreas (with videos). Gastrointest Endosc 2011; 74: 1049-1060
- 12 Bown SG, Rogowska AZ, Whitelaw DE et al. Photodynamic therapy for cancer of the pancreas. Gut 2002; 50: 549-557
- 13 Ayaru L, Bown SG, Pereira SP. Photodynamic therapy for pancreatic and biliary tract carcinoma. Int J Gastrointest Cancer 2005; 35: 1-13
- 14 Kim HJ, Seo DW, Hassanuddin A et al. EUS-guided radiofrequency ablation of the porcine pancreas. Gastrointest Endosc 2012; 76: 1039-1043
- 15 Huggett MT, Jermyn M, Gillams A et al. Phase I/II study of verteporfin photodynamic therapy in locally advanced pancreatic cancer. Br J Cancer 2014; 110: 1698-1704