Interstitielle Photodynamische Lasertherapie zur Behandlung von Lebermetastasen: Erste Ergebnisse einer in vivo Phase I-Studie

Zusammenfassung

Ziel: Entwicklung und Evaluation einer neuen photodynamischen Technik zur Lasertherapie von Lebertumoren im Rahmen einer Phase I-Studie. Methode: Durch Anwendung neuer Kathetersysteme wird die photodynamische Lasertherapie auch zur Therapie von Tumoren parenchmyatöser Organe einsetzbar. Im Rahmen einer multizentrischen Phase I-Studie haben wir 5 Patienten mit Lebermetastasen kolorektaler Tumoren mittels interstitieller photodynamischer Technik mit dem neu entwickelten Photosensibilisator SQN 400 und nach 5 Tagen folgender Lasertherapie behandelt. Die Tumorbeurteilung erfolgte durch kontrastverstärkte Computertomographie (CT) im Verlauf. Ergebnisse: Die kontrastverstärkten CT-Aufnahmen konnten zeigen, dass sich im Radius von ca. 1 cm um die Lichtfasern eine komplette Nekrose erzielen ließ und sich bei Verwendung mehrerer Fasern Lebertumoren abtragen lassen. Schwerwiegende Nebenwirkungen oder Toxizitäten traten nicht auf. Schlussfolgerung: Die photodynamische Lasertherapie von Lebertumoren ist ein minimalinvasives, nebenwirkungsarmes Verfahren mit Induktion von scharf begrenzten kleinvolumigen Nekrosen.

Abstract

Purpose: Development and evaluation of a new photodynamic treatment technique for the laser therapy of liver malignancies Material and Methods: The combination with new catheter systems enables the use of the photodynamic therapy (PDT) to treat also tumors in parenchymal organs. So far it is mainly used to treat superficial or endoluminal tumors. The presented study is part of a multicenter phase I-study. We treated 5 patients with colorectal liver metastases with the new photosensitizer SQN 400 and following interstitial photodynamic laser treatment. Evaluation of tumors were performed by contrastenhanced CT scans. Results: In the contrast enhanced CT scans the development of a complete necrosis within a radius of 1 cm around every single fibre could be shown. Additional the ablation of tumors with the combined use of several fibres is possible. Severe complications or toxicities were not observed. Conclusion: The photodynamic laser therapy of liver malignancies is a minimal invasive procedure with little side effects which produces sharply defined yet small volumes of necrosis.

Key words

Photodynamic therapy - laser therapy - minimal invasive procedures - liver malignancies

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