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Sakhiya J, Sakhiya D, Kaklotar J, Hirapara B, Purohit M, Bhalala K, Daruwala F, Dudhatra N. Intralesional Agents in Dermatology: Pros and Cons. J Cutan Aesthet Surg 2021; 14:285-295. [PMID: 34908770 PMCID: PMC8611707 DOI: 10.4103/jcas.jcas_109_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Since introduced in 1961, intralesional (IL) agent has become an essential part of the dermatological practice. The term IL referred to the direct delivery of agent percutaneously into skin lesions. This therapeutic approach is relatively safe, easy to perform and applicable for a broad range of dermatological conditions. On the other hand, immediate side effects, including pain during administration, bleeding, high risk of infection and allergic reaction, and subsequent side effects involving skin changes such as atrophy, telangiectasia, pigmentary changes, and striae are usually associated with this modality. This review paper highlights the pros and cons of IL agents in modern dermatology practice.
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Affiliation(s)
- Jagdish Sakhiya
- Sakhiya Skin Clinic, 2nd Floor, Ayush Doctor House, Station-Lal Darwaja Road, Surat, Gujarat, India
| | - Dhruv Sakhiya
- B.J. Medical College, New Civil Hospital Asarwa, Ahmedabad, Gujarat, India
| | - Jitesh Kaklotar
- Sakhiya Skin Clinic, 2nd Floor, Ayush Doctor House, Station-Lal Darwaja Road, Surat, Gujarat, India
| | - Bansi Hirapara
- Sakhiya Skin Clinic, 2nd Floor, Ayush Doctor House, Station-Lal Darwaja Road, Surat, Gujarat, India
| | - Madhav Purohit
- Sakhiya Skin Clinic, 2nd Floor, Ayush Doctor House, Station-Lal Darwaja Road, Surat, Gujarat, India
| | - Krishna Bhalala
- Sakhiya Skin Clinic, 2nd Floor, Ayush Doctor House, Station-Lal Darwaja Road, Surat, Gujarat, India
| | - Feral Daruwala
- Sakhiya Skin Clinic, 2nd Floor, Ayush Doctor House, Station-Lal Darwaja Road, Surat, Gujarat, India
| | - Nimish Dudhatra
- Sakhiya Skin Clinic, 2nd Floor, Ayush Doctor House, Station-Lal Darwaja Road, Surat, Gujarat, India
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Abstract
Background Jet injection can be defined as a needle-free drug delivery method in which a high-speed stream of fluid impacts the skin and delivers a drug. Despite 75 years of existence, it never reached its full potential as a strategic tool to deliver medications through the skin. Objective The aim of this review was to evaluate and summarize the evolution of jet injection intradermal drug delivery method including technological advancements and new indications for use. Methods A review of the literature was performed with no limits placed on publication date. Results Needleless injectors not only reduce pain during drug delivery but also confine the drug more evenly in the dermis. Understanding skin properties of the injection site is a key factor to obtain optimal results as well as setting the right parameters of the jet injector. Until the advent of disposable jet injectors/cartridges, autoclaving of the injector remains the only reliable method to eliminate the risk of infection. Needle-free intradermal injection using corticosteroids and/or local anesthetics is well documented with promising indications being developed. Limitations Limitations of the review include low-quality evidence, small sample sizes, varying treatment parameters, and publication bias. Conclusion New developments may help reconsider the use of jet injection technology. Future studies should focus on measurable optimized parameters to insure a safe and effective outcome.
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Affiliation(s)
- Daniel Barolet
- RoseLab Skin Optics Research Laboratory, Laval, QC, Canada.,MUHC Dermatology Service, Department of Medicine, McGill University, Montreal, QC, Canada
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Gong Y, Labh S, Jin Y, Diao HY, Li XL, Liu ZY, Shi YL. Needle-free injection of 5-aminolevulinic acid in photodynamic therapy for the treatment of non-melanoma skin cancer. Dermatol Ther 2016; 29:255-62. [PMID: 26811297 DOI: 10.1111/dth.12335] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Yu Gong
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
| | - Sony Labh
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
| | - Yi Jin
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
| | - Hong-Yue Diao
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
| | - Xiu-Li Li
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
| | - Zhi-Yu Liu
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
| | - Yu-Ling Shi
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
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Barber K, Searles GE, Vender R, Teoh H, Ashkenas J. Non-melanoma Skin Cancer in Canada Chapter 2: Primary Prevention of Non-melanoma Skin Cancer. J Cutan Med Surg 2015; 19:216-26. [PMID: 25775622 DOI: 10.1177/1203475415576465] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Non-melanoma skin cancer (NMSC), including basal and squamous cell carcinoma (BCC and SCC), represents the most common malignancy. OBJECTIVE To provide guidance to Canadian health care practitioners regarding primary prevention of NMSC. METHODS Structured literature searches were conducted, using search terms including prevention, sunscreen, and sun prevention factor. All recommendations concern guidance that physicians should regularly discuss with their patients to help establish photoprotection habits. The GRADE system was used to assign strength to each recommendation. RESULTS Ultraviolet exposure is the major modifiable risk factor for NMSC. Aspects of photoprotection, including effective sunscreen use and avoidance of both the midday sun and artificial tanning, are discussed. Several widespread misunderstandings that undermine responsible public health measures related to sun safety are addressed. CONCLUSIONS Photoprotection represents both an individual priority and a public health imperative. By providing accurate information during routine patient visits, physicians reinforce the need for ongoing skin cancer prevention.
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Affiliation(s)
- Kirk Barber
- Kirk Barber Research, Calgary, AB, Canada University of Calgary, Calgary, AB, Canada
| | | | - Ronald Vender
- Dermatrials Research, Hamilton, ON, Canada McMaster University, Hamilton, ON, Canada
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Li X, Wang X, Gu J, Ma Y, Liu Z, Shi Y. Needle-free injection of 5-aminolevulinic acid in photodynamic therapy for the treatment of condylomata acuminata. Exp Ther Med 2013; 6:236-240. [PMID: 23935753 PMCID: PMC3735532 DOI: 10.3892/etm.2013.1092] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 04/19/2013] [Indexed: 12/02/2022] Open
Abstract
The external application of 5-aminolevulinic acid (ALA) in photodynamic therapy (PDT) results in a shallow penetration depth in thick or extensive condylomata acuminata (CA) lesions, thus demonstrating a poor therapeutic effect for those patients. To compare the efficacy of needle-free injection with external application of ALA in PDT for the treatment of CA, 160 CA patients with thick or extensive warts received ALA-PDT by means of external application or needle-free injection of ALA, respectively. The complete response (CR) rate and recurrence rate in the two groups were analyzed. The CR rate after the first treatment in the needle-free injection group (68.8%) was significantly higher compared with that in the external application group (52.5%; P=0.035). The recurrence rates in the needle-free injection group and external application group were 4.1 and 15.4%, respectively (P=0.022). The needle-free injection of ALA increases the therapeutic effect of PDT for CA patients with thick or extensive lesions. It shortens the treatment time and reduces the recurrence rate, and has great potential in the treatment of CA.
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Affiliation(s)
- Xiuli Li
- Department of Dermatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
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Photodynamic therapy with intralesional photosensitizer and laser beam application: an alternative treatment for nodular basal cell carcinoma. J Am Acad Dermatol 2012; 67:e134-6. [PMID: 22980263 DOI: 10.1016/j.jaad.2011.10.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Revised: 10/18/2011] [Accepted: 10/19/2011] [Indexed: 11/21/2022]
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Kim SK, Shin J, Kim YC. Nodular Basal cell carcinoma successfully treated with intralesional 5-aminolevulinic Acid injection-photodynamic therapy. Ann Dermatol 2012. [PMID: 23197924 PMCID: PMC3505789 DOI: 10.5021/ad.2012.24.4.486] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sue Kyung Kim
- Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
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Abstract
Localized resistant plaques of psoriasis often remain despite highly effective anti-psoriasis treatment. Intralesional therapy is often used to treat various malignant, infectious or inflammatory cutaneous diseases, including psoriasis. Despite the presence of many review articles on the treatment of psoriasis, no articles exist which review the use of intralesional therapy for psoriasis. In this article, we review the published literatures of intralesional therapy for psoriasis. Corticosteroids, methotrexate, cyclosporin, biologics, botulinum toxin type-A, 15-hydroxyeicosatetraenoic acid, and chemotherapy agents such as 5-fluorouracil are discussed. Also, agents which may be used intralesionally and have the potential to treat psoriasis will also be reviewed such as bleomycin, vincristine or vinblastine, mitomycin-C, aminophylline, 5-aminolevulinic acid, rituximab, bevacizumab and pentoxifylline are included.
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Affiliation(s)
- Ting-Shun Wang
- Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan, Republic of China
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Evangelou G, Krasagakis K, Giannikaki E, Kruger-Krasagakis S, Tosca A. Successful treatment of cutaneous leishmaniasis with intralesional aminolevulinic acid photodynamic therapy. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2012; 27:254-6. [PMID: 21950631 DOI: 10.1111/j.1600-0781.2011.00610.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Leishmaniasis is a protozoan infectious disease that often affects the skin and may acquire a chronic and difficult to treat course. Topical photodynamic therapy (PDT) is a novel treatment which involves the selective uptake of a photosensitizing agent. Exposure to an appropriate light source in the presence of oxygen leads to formation of reactive oxygen species and destruction of the target cells. We report on the successful treatment of a 69-year-old patient with a relapse of long-standing cutaneous leishmaniasis using intralesional aminolevulinic acid-PDT.
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Affiliation(s)
- George Evangelou
- Department of Dermatology, University Hospital of Heraklion, Heraklion, Crete, Greece.
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Harris F, Pierpoint L. Photodynamic therapy based on 5-aminolevulinic acid and its use as an antimicrobial agent. Med Res Rev 2011; 32:1292-327. [PMID: 21793017 DOI: 10.1002/med.20251] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Exogenous 5-aminolevulinic acid (ALA) is taken up directly by bacteria, yeasts, fungi, and some parasites, which then induces the accumulation of protoporphyrin IX (PPIX). Subsequent light irradiation of PPIX leads to the inactivation of these organisms via photodamage to their cellular structures. ALA uptake and light irradiation of PPIX produced by host cells leads to the inactivation of other parasites, along with some viruses, via the induction of an immune response. ALA-mediated PPIX production by host cells and light irradiation result in the inactivation of other viruses via either the induction of a host cell response or direct photodynamic attack on viral particles. This ALA-mediated production of light-activated PPIX has been extensively used as a form of photodynamic therapy (PDT) and has shown varying levels of efficacy in treating conditions that are associated with microbial infection, ranging from acne and verrucae to leishmaniasis and onychomycosis. However, for the treatment of some of these conditions by ALA-based PDT, the role of an antimicrobial effect has been disputed and in general, the mechanisms by which the technique inactivates microbes are not well understood. In this study, we review current understanding of the antimicrobial mechanisms used by ALA-based PDT and its role in the treatment of microbial infections along with its potential medical and nonmedical applications.
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Affiliation(s)
- Frederick Harris
- School of Forensic and Investigative Sciences, University of Central Lancashire, Preston, Lancashire, United Kingdom. fharris1@.ac.uk
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Kim JE, Kim SJ, Hwang JI, Lee KJ, Park HJ, Cho BK. New proposal for the treatment of viral warts with intralesional injection of 5-aminolevulinic acid photodynamic therapy. J DERMATOL TREAT 2011; 23:192-5. [DOI: 10.3109/09546634.2010.551534] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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No-needle jet intradermal aminolevulinic Acid photodynamic therapy for recurrent nodular Basal cell carcinoma of the nose: a case report. J Skin Cancer 2010; 2011:790509. [PMID: 21188233 PMCID: PMC3003975 DOI: 10.1155/2011/790509] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Revised: 09/17/2010] [Accepted: 09/23/2010] [Indexed: 12/22/2022] Open
Abstract
Photodynamic therapy (PDT) with aminolevulinic acid (ALA) to treat nodular basal cell carcinoma (BCC) has been shown to be beneficial. The success rate of ALA-PDT in the treatment of nodular BCC is dependent on optimal penetration of the photosensitizing agent and subsequent PpIX production. To enhance topical delivery of drugs intradermally, a needleless jet injection (NLJI), which employs a high-speed jet to puncture the skin without the side effects of needles, was used in one patient with recurrent BCC of the nose. Photoactivation was then performed using red light emitting diode [CW @ λ 630 nm, irradiance 50 mW/cm2, total fluence 51 J/cm2] for 17 minutes. Excellent cosmesis was obtained. Aside from mild crusting present for six days, no other adverse signs were noted. Clinically, there was no recurrent lesion up two years postintervention. Additional studies in larger samples of subjects are needed to further evaluate this promising technique.
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Sotiriou E, Apalla Z, Ioannides D. Complete resolution of a squamous cell carcinoma of the skin using intralesional 5-aminolevulinic acid photodynamic therapy intralesional PDT for SCC. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2010; 26:269-71. [DOI: 10.1111/j.1600-0781.2010.00531.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Good LM, Miller MD, High WA. Intralesional agents in the management of cutaneous malignancy: a review. J Am Acad Dermatol 2010; 64:413-22. [PMID: 20334952 DOI: 10.1016/j.jaad.2009.12.013] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2009] [Revised: 12/02/2009] [Accepted: 12/06/2009] [Indexed: 12/17/2022]
Abstract
Intralesional agents have a role in the management of cutaneous malignancies. In this article, the efficacy, side effects, strengths, limitations, costs, and practical considerations regarding the use of intralesional agents to treat basal cell carcinoma, squamous cell carcinoma, selected cutaneous lymphomas, and even metastatic melanoma are reviewed. Intralesional administration of 5-fluorouracil, interferon, interleukin-2, bleomycin with electrochemotherapy, and aminolevulinic acid with photodynamic therapy are discussed as treatment modalities in basal cell carcinoma. Interferon (∼1.5 M IU, 3 times weekly × 3 weeks) is perhaps the most widely used regimen for basal cell carcinoma. With regard to squamous cell carcinoma, treatment with 5-fluorouracil, methotrexate, interferon, and bleomycin are reviewed. Methotrexate (∼0.3-2.0 mL of 12.5 or 25 mg/mL, two injections ∼2 weeks apart) was perhaps the most widely used agent. Interferon (3 M IU × 3 times weekly for ∼8.5 weeks) and rituximab (10-30 mg per lesion, 3 times weekly for 1 week, possibly repeated 4 weeks later) are sometimes used in the management of primary cutaneous B-cell lymphomas, whereas in primary cutaneous CD30(+) lymphoma intralesional methotrexate (0.4-0.5 mL of 50 mg/mL weekly for 2 weeks) has been used. Finally, the roles of BCG vaccine, cidofovir, rose bengal, and bleomycin with electrochemotherapy for the palliation of metastatic melanoma are reviewed. Intralesional management appears most useful when surgical intervention is not a viable option, for cases in which the cosmetic outcome may be superior, or for situations in which the side effects from systemic chemotherapeutic agents are to be minimized.
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Affiliation(s)
- Laurie M Good
- Department of Dermatology, University of Colorado Health Sciences Center, Denver, CO, USA
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Lin MH, Lee JYY, Ou CY, Wong TW. Sequential systemic retinoid and photodynamic therapy for multiple keratotic pigmented nodular basal cell carcinomas on the scalp. J Dermatol 2009; 36:518-21. [PMID: 19712282 DOI: 10.1111/j.1346-8138.2009.00692.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sandberg C, Halldin CB, Ericson MB, Larkö O, Krogstad AL, Wennberg AM. Bioavailability of aminolaevulinic acid and methylaminolaevulinate in basal cell carcinomas: a perfusion study using microdialysis in vivo. Br J Dermatol 2008; 159:1170-6. [PMID: 18717673 DOI: 10.1111/j.1365-2133.2008.08795.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Photodynamic therapy is becoming a popular treatment for superficial nonmelanoma precancerous and cancerous lesions, showing excellent cosmetic results. Nevertheless, the reported cure rates vary and the transdermal penetration of drugs has been discussed as a limiting factor, particularly for treatment of nodular basal cell carcinoma (BCC). OBJECTIVES To investigate the transdermal penetration of aminolaevulinic acid (ALA) and methylaminolaevulinate (MAL) in BCC in vivo using a microdialysis technique. The different prodrugs were compared and the effect of curettage was studied. METHODS Twenty patients with 27 histologically verified BCCs (13 superficial, 14 nodular) were included. All lesions were located at the front of the body (head and face excluded). The first 10 patients included were treated with MAL (13 BCCs), and the following 10 patients with ALA (14 BCCs). A light curettage was performed on every second lesion (curettage, n = 13; noncurettage, n = 14). Microdialysis catheters were inserted into the tumours at tissue depths varying from 0.4 to 1.9 mm. Dialysates were collected at 15-30-min intervals for 4 h and the interstitial concentrations of MAL and ALA were determined using high-performance liquid chromatography. RESULTS No significant difference in interstitial drug concentration was observed between lesions treated with ALA or MAL during the 4-h measurement period. However, for the lesions with deeper catheter locations, i.e. at or below 1 mm (n = 11), drug concentrations above the detection limit were obtained in only six lesions. All but one BCC with superficial catheter location, i.e. < 1 mm (n = 16), exhibited detectable drug concentration (P = 0.026). The interstitial peak concentrations were reached within 90 min in 23 of the 27 BCCs, but were not found to be correlated with the depth of the catheters. No difference was found when comparing superficial and nodular BCCs, and the effect of curettage was found to be negligible. CONCLUSIONS The results imply that there is no significant difference in transdermal penetration of ALA and MAL in tumour tissue. Detectable levels of drug were not obtained in almost 50% of the lesions where catheters were situated 1-1.9 mm in the lesion. Curettage was not found to affect the interstitial concentration, indicating that penetration of drug indeed might be a problem when treating BCCs thicker than 1 mm.
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Affiliation(s)
- C Sandberg
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Gothenburg University, S-413 45 Gothenburg, Sweden.
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Salvini C, Massi D, Cappugi P. Recurrent basal cell carcinoma of the nose successfully treated by photodynamic therapy. J Eur Acad Dermatol Venereol 2008; 23:73-5. [PMID: 18462294 DOI: 10.1111/j.1468-3083.2008.02669.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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MacCormack MA. Photodynamic Therapy in Dermatology: An Update on Applications and Outcomes. ACTA ACUST UNITED AC 2008; 27:52-62. [DOI: 10.1016/j.sder.2007.12.001] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Zhu TC, Finlay JC. Prostate PDT dosimetry. Photodiagnosis Photodyn Ther 2006; 3:234-46. [PMID: 25046988 PMCID: PMC4469490 DOI: 10.1016/j.pdpdt.2006.08.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2006] [Revised: 08/17/2006] [Accepted: 08/22/2006] [Indexed: 11/15/2022]
Abstract
We provide a review of the current state of dosimetry in prostate photodynamic therapy (PDT). PDT of the human prostate has been performed with a number of different photosensitizers and with a variety of dosimetry schemes. The simplest clinical light dose prescription is to quantify the total light energy emitted per length (J/cm) of cylindrical diffusing fibers (CDF) for patients treated with a defined photosensitizer injection per body weight. However, this approach does not take into account the light scattering by tissue and usually underestimates the local light fluence rate, and consequently the fluence. Techniques have been developed to characterize tissue optical properties and light fluence rates in vivo using interstitial measurements during prostate PDT. Optical methods have been developed to characterize tissue absorption and scattering spectra, which in turn provide information about tissue oxygenation and drug concentration. Fluorescence techniques can be used to quantify drug concentrations and photobleaching rates of photosensitizers.
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Affiliation(s)
- Timothy C. Zhu
- Department of Radiation Oncology, University of Pennsylvania, 3400 Spruce Street/2 Doner Bldg., Philadelphia, PA 19104, USA
| | - Jarod C. Finlay
- Department of Radiation Oncology, University of Pennsylvania, 3400 Spruce Street/2 Doner Bldg., Philadelphia, PA 19104, USA
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Stylli SS, Kaye AH. Photodynamic therapy of cerebral glioma – A review Part II – Clinical studies. J Clin Neurosci 2006; 13:709-17. [PMID: 16567094 DOI: 10.1016/j.jocn.2005.11.012] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2005] [Accepted: 11/27/2005] [Indexed: 01/02/2023]
Abstract
Photodynamic therapy (PDT) is a binary treatment modality that has been used to treat malignant brain tumours for 25 years. The treatment involves the selective uptake of a photosensitizer (PS) by the tumour cells followed by irradiation of the tumour with light of the appropriate wavelength to excite and activate the PS resulting in selective tumour destruction and is a potentially valuable adjunct to surgical excision and other conventional therapies. PDT has undergone extensive laboratory studies and clinical trials with a variety of PS and tumour models. These are discussed with reference mainly to clinical studies involving the PDT of brain tumours.
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Affiliation(s)
- Stanley S Stylli
- Department of Neurosurgery, Department of Surgery, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria 3052, Australia.
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Stylli SS, Kaye AH. Photodynamic therapy of cerebral glioma – A review Part I – A biological basis. J Clin Neurosci 2006; 13:615-25. [PMID: 16554159 DOI: 10.1016/j.jocn.2005.11.014] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2005] [Accepted: 11/27/2005] [Indexed: 11/16/2022]
Abstract
Photodynamic therapy (PDT) has been investigated extensively in the laboratory for decades, and for over 25 years in the clinical environment, establishing it as a useful adjuvant to standard treatments for many cancers. A combination of both photochemical and photobiological processes occur that lead to the eventual selective destruction of the tumour cells. It is a potentially valuable adjuvant therapy that can be used in conjunction with other conventional therapies for the treatment of cerebral glioma. PDT has undergone extensive laboratory studies and clinical trials with a variety of photosensitizers (PS) and tumour models of cerebral glioma. Many environmental and genetically based factors influence the outcome of the PDT response. The biological basis of PDT is discussed with reference to laboratory and preclinical studies.
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Affiliation(s)
- Stanley S Stylli
- Department of Neurosurgery, 5th Floor Clinical Sciences Building, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria 3052, Australia.
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