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Query: UMLS:C0242379 (lung cancer)
 71,905 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical application of photodynamic therapy (PDT) began in the late 1970's. Hematoporphyrin derivative has been used as a photosensitizer and recently Photofrin II (Dihematoporphyrin ether, DHE) was also developed as a second generation photosensitizer. The argon dye laseris used to excite the photosensitizer, however an eximer dye laser was recently developed as more effective laser. In a multicenter research study project team (7 institutions) on photodynamic therapy organized by the Ministry of Health and Welfare, 133 cases of gastric cancer (including 120 cases of early stage cancer), 209 cases of lung cancer (69 cases of early stage cancer), 66 cases of esophageal cancer (22 cases of early stage cancer), 68 cases of bladder cancer (68 cases of early stage cancer), and 86 cases of other organ cancers were treated. In early stage cancer cases 77.3% showed complete remission (CR) but among those the recurrence was 15.7% in lung cancer cases and opposed to 100% CR and 22.2% recurrence in gastric cancer cases, 80% CR and no recurrence in esophageal cancer cases, and 68.6% CR and 58.3% recurrence in bladder cancer cases. Especially in limited lesions less than 1 cm in diameter, the CR was obtained in 100% and the recurrence was recognized in only 1 (2.6%) of 28 lung cancer lesions, 100% CR and no recurrence was obtained in 30 lesions of gastric cancer and also 100% CR with no recurrence was recognized in 16 lesions in bladder cancer. This study suggests that PDT has the potential to cure early stage cancer lesions.
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PMID:[Photodynamic therapy in the early treatment of cancer]. 220 15

Photoradiation therapy with hematoporphyrin derivative was used in 13 cases of early-stage and eight cases of stage 1 central-type lung cancer. The lesions were photoradiated superficially or interstitially by an argon dye laser with a power of 80 to 600 mW for 10 to 40 minutes at 48 hours or more after intravenous injection of 2.5 to 5.0 mg of hematoporphyrin derivative (Photofrin) per kilogram of body weight. Eight of the 13 early-stage cases were treated with photoradiation only, due to poor pulmonary function or refusal of surgery. Macroscopically complete tumor remission was obtained in all eight cases, and the patients are free of disease at 13 to 41 months after photoradiation therapy, except two patients who died at 16 and 31 months after therapy, due to chronic obstructive pulmonary disease and cerebral infarction, respectively. Five cases were resected following photoradiation therapy. Complete remission was demonstrated histologically in two and significant remission in three, and all are free of disease at 7 to 30 months after surgery. The histologic type was squamous cell carcinoma in all cases. In eight stage 1 cases (seven squamous cell carcinomas and one large cell carcinoma), surgery was performed in three after photoradiation therapy, and the remaining five cases were not resected, due to poor pulmonary function or refusal of surgery. Apparent complete remission was obtained in two of the nonresected cases (one died of cerebral infarction at 27 months, while recurrence occurred 15 months after photoradiation therapy in the other) and significant remission in six. In three nonresected cases with significant remission, two patients died of pneumonia unrelated to the photoradiation treatment at 11 and 4 months, respectively, after such treatment. The reason why only significant remission was obtained in early and stage-1 cases was due to the penetration of the argon dye laser beam being limited due to the location of the tumor or the degree of intrabronchial or extrabronchial growth in eight cases. In one other case the power of the argon dye laser beam was insufficient due to technical difficulties. Indications for photoradiation therapy were discussed in relation to the histologic findings in the specimens following such therapy. Procedures were performed under local anesthesia in all cases. Our results indicate that with present methods, photoradiation therapy is effective in cases of superficial invasion or intramural invasion, but curative effects can hardly be expected in cases growing beyond the normal muscular or cartilaginous layer.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Photoradiation therapy with hematoporphyrin derivative in early and stage 1 lung cancer. 623 3

Porfimer sodium (Photofrin II) is a photosensitizer which distributes selectively to tumor tissues, and causes tumor cell death by combination with light irradiation. Photodynamic therapy (PDT) by combination of porfimer sodium and laser was developed as a new cancer therapy. Tumor selectivity of porfimer sodium are based on the following reasons; 1) high affinity for lipoprotein, especially, low density lipoprotein (LDL), 2) elevation of LDL receptor activity in cancer tissue, and 3) lack or imcompleteness of lymphatic system in cancer tissue. Porfimer sodium is activated by laser irradiation at 630 nm, which can reacts with tissue oxygen to produce highly reactive excited siglet oxygen (1O2). This highly reactive molecule is subsequently capable of killing tumor cells through oxidation of cellular component like mitochondrial enzymes. In addition, this highly reactive intermediate causes destruction of the tumor capillaries, which accelerates tumor cell death. The growth suppression or lethal damage to tumor cells by PDT of porfimer sodium and excimer dye laser were observed in experimental tumor models. In human clinical trials, the rates of complete response (CR) for roentgenographically occult lung cancer, stage I lung cancer, superficial esophageal cancer, superficial gastric cancer and carcinoma in situ or dysplasia of the cervix were 84.8%, 50.0%, 90.0%, 87.5% and 94.4%, respectively. The major side effects were cutaneous symptoms e.g. photosensitivity, pigmentation, increasing GOT, GPT but these symptoms were not severe. PDT using porfimer sodium and excimer dye laser must be clinically useful for the treatment of inoperable early cancer or conservation of organ functions.
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PMID:[Porfimer sodium (Photofrin-II)]. 766 80

Photodynamic therapy (PDT) has been used investigationally for the treatment of lung cancer since 1980. Following systemic administration of a photosensitizing agent such as porfimer sodium (Photofrin; manufactured by Lederle Parenterals, Carolina, Puerto Rico, under license from Quadra Logic Technologies, Inc, Vancouver, British Columbia, Canada), specialized optical delivery systems are engaged to deliver light of a specific wavelength (630 nm for porfimer sodium) to neoplastic tissue. A promising use of PDT appears to be treatment of early stage lung carcinoma. Phase I-II clinical trials by Hayata's group in Japan showed that for superficial early lung cancer less than 1 cm in surface diameter, complete eradication can be achieved in approximately 90% of cases. Additional phase II-III clinical trials have demonstrated an average of 90% complete response rates for superficial tumors less than 1 cm in diameter. Preoperative PDT may be useful for larger neoplasms to reduce tumor burden and potentially lessen the degree of surgery required. At the British Columbia Cancer Agency, 22 patients with 30 radiologically occult cancers were treated with PDT. In contrast to Hayata's studies, most of these patients had rather extensive tumor burden. Thirty percent of the tumors involved two or more bronchi, and more than half of them were greater than 1 cm in surface diameter. Twenty-three percent of the cases were bronchial stump recurrences. In the group of patients with bronchial stump recurrence, although a complete response was obtained with PDT initially, local recurrences occurred in 75% of cases. These results suggest that recurrent tumor in the bronchial stump should not be treated with PDT because of difficulty in delivering light endobronchially to distal tissues. Photodynamic therapy may have a role in the palliation of advanced, inoperable, obstructive bronchial tumors. Phytodynamic therapy in combination with external radiotherapy may produce better local control than external radiotherapy alone in patients with obstructive bronchial cancers. Photodynamic therapy and conventional Nd:YAG laser therapy appear to be equally effective in relieving intraluminal obstruction by tumor. An advantage of PDT for this purpose is longer time to treatment failure; a disadvantage is photosensitization that usually occurs for up to 4 weeks after treatment. In summary, PDT is a promising curative treatment for patients with small early bronchial cancers.
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PMID:Photodynamic therapy of lung cancer. 799 2

Photodynamic therapy utilizing Photofrin has proven to be an effective modality that can be used in the treatment of a wide variety of solid tumors and luminal cancers. An argon pumped dye laser or excimer dye laser was used to deliver 630 nm light via quartz fibers passed through the biopsy channel subsequent to i.v. injection of photosensitizer. In this study, 64 patients with superficial cancers were treated in this manner but only 58 patients, including 21 with roentgenographically occult lung cancer, 8 with stage I lung cancer, 5 with esophageal cancer, 12 with gastric cancer, 8 with cervical cancer and 4 with bladder cancer were evaluable. Complete remission was obtained in 48 out of 58 cases (82.8%). There was no serious complication except skin photosensitivity, which was seen in 13 patients. We conclude that photodynamic therapy is efficacious in the treatment of superficial cancers where complete remission may be achieved.
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PMID:Photodynamic therapy for cancers: a clinical trial of porfimer sodium in Japan. 827 25

Photodynamic therapy is achieved by a photodynamic reaction which is induced by excitation of photosensitizer exposed to light. This phenomenon was first reported by Raab et al in 1990. In 1960 Lipson et al reported hematoporphyrin derivative (HpD) by treating hematoporphyrin chloride with hydrochloric acid and sulfuric acid. The development of HpD established the basis of today's photodynamic therapy (PDT). Dougherty reported the treatment of skin tumors by PDT first with an argon dye laser in 1978. The author and his colleagues began basic studies of this treatment using HpD supplied by Dougherty and argon dye laser in canine lung cancer in 1978. These studies confirmed the effectiveness and safety of the method. Bronchofiberscopic PDT for early stage central type squamous cell carcinoma was performed by the authors in 1980 for the first time in the world and complete cure was obtained. Since then PDT has been attracted much attention. The photosensitizer and the laser with a specific wavelength are the key point of PDT. Photofrin, a porfimer sodium (Japan Lederle Co. Ltd., Tokyo, Japan) and excimer dye laser (Hamamatsu Photonics Co. Ltd., Hamamatsu, Japan) obtained governmental approval for clinical use in Japan in 1994, which is equivalent to FDA approval in the US. This method is now used clinically in Canada for certain indications and the Netherlands. In the US it is only approved for compassionate use in cancer of the esophagus. A total of more than 3,000 tumors in the various organs have been treated by PDT so far in 32 countries. The most frequently treated organ is the lung, with 808 cases. A phase II clinical study of PDT for early stage cancer cases of the lung, esophagus, stomach, cervix and urinary bladder was performed in 15 institutions from 1989 to early 1992. The results showed that PDT can successfully treat more than at least 50% of patients with early stage cancer cancer that would otherwise have to be treated by surgery and this means that PDT can contribute to their QOL. The cost effectiveness of PDT versus operation was estimated by the calculation based on QALY's (Quality Adjusted Life Year's saved) by Fujino of the Economics Department of Chuo University. According to this calculation PDT was estimated to be at least 30 percent less than the cost of operation. PDT is indicated in cases with superficial localized early stage lung cancer as a curative treatment and as a palliative treatment for opening stenotic or obstructed bronchi due to tumor prior to the combination therapy with surgery. Recent studies on photodynamic therapy (PDT) began just two decades ago, therefore there are still a large number of unsolved problems. However PDT will have many applications in a wide range of fields from preclinical to clinical medical science. In lung cancer, the indications will be extended for early stage lung cancer and improvement of therapeutic results will be achieved by the development of new photosensitizers such as chlorin, pheophorbide, phthalocyanin, ALA, benzoporphyrin, etc which can be excited by longer wavelength and new lasers such as pulsed excimer dye, YAG-OPO and diode lasers. Through these new developments the indications of this treatment for malignant will continue to expand.
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PMID:[History of photodynamic therapy--past, present and future]. 854 74

The first reports on photodynamic therapy (PDT) date back to the 1970s. Since then, several thousands of patients, both with early stage and advanced stage solid tumours, have been treated with PDT and many claims have been made regarding its efficacy. Nevertheless, the therapy has not yet found general acceptance by oncologists. Therefore it seems legitimate to ask whether PDT can still be described as "a promising new therapy in the treatment of cancer". Clinically, PDT has been mainly used for bladder cancer, lung cancer and in malignant diseases of the skin and upper aerodigestive tract. The sensitizer used in the photodynamic treatment of most patients is Photofrin, (Photofrin, the commercial name of dihematoporphyrin ether/ester, containing > 80% of the active porphyrin dimers/oligomers (A.M.R. Fisher, A.L. Murphee and C.J. Gomer, Clinical and preclinical photodynamictherapy, Review Series Article, Lasers Surg. Med., 17 (1995) 2-31). It is a complex mixture of porphyrins derived from hematoporphyrin. Although this sensitizer is effective, it is not the most suitable photosensitizer for PDT. Prolonged skin photosensitivity and the relatively low absorbance at 630 nm, a wavelength where tissue penetration of light is not optimal, have been frequently cited as negative aspects hindering general acceptance. A multitude of new sensitizers is currently under evaluation. Most of these "second generation photosensitizers" are chemically pure, absorb light at around 650 nm or greater and induce no or less general skin photosensitivity. Another novel approach is the photosensitization of neoplasms by the induction of endogenous photosensitizers through the application of 5-aminolevulinic acid (ALA). This article addresses the use of PDT in the disciplines mentioned above and attempts to indicate developments of PDT which could be necessary for this therapy to gain a wider acceptance in the various fields.
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PMID:Photodynamic therapy: a promising new modality for the treatment of cancer. 876 58

Laser endoscopic surgery has now achieved a status as effective therapeutic modality for lung cancer. Especially increasing attention has been focused on photodynamic therapy (PDT) using Photofrin and excimer dye laser. PDT obtained government approval in October 1994 and finally obtained national insurance reimbursement status in April 1996. Over the past decade, 248 patients (296 lesions) with central type lung cancers have been treated in our hospital. Overall complete remission was obtained in 42.5% of the 125 lesions, partial remission in 56.8% and no remission was obtained in 1.0%. Indications of PDT are follows, 1. Early stage lung cancer as a curative purpose: among 104 early stage lesions CR was obtained in 87 (83.7%) and 61 cases were disease free at 2 to 178 months. 2. Advanced lesions for opening of bronchi: overall, "effective" opening of bronchi was achieved in 61 out of 81 lesions (75%) for the PDT group, as opposed to 143 of 177 (81%) for the Nd-YAG laser therapy group. 3. Preoperative laser irradiation for the propose of increasing operability and reducing the extent of resection area: the initial purpose of PDT, i.e., either reduction of extent of resection of conversion of inoperable disease to operable status, was achieved in 21 out of 21 patients treated. 4. Multiple primary lung cancer. The success from clinical trials using PDT for treatment of cancers offers encouragement for its future use. More stable, definitive and more successful results will be obtained if new dyes which distribute more equally in the tumor tissue and deeper tissue penetration by longer wavelength beams are used.
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PMID:[Photodynamic therapy for bronchogenic carcinoma]. 904 16

Photodynamic therapy (PDT) is an innovative and attractive modality for the treatment of small and superficial tumours. PDT, as a multi-modality treatment procedure, needs both, a photosensitizer with distinct tumour selectivity and a powerful light source that matches the absorption spectrum of the photosensitizer. The purified haematoporphyrin derivative Photofrin is so far the only sensitizer approved for phase III/IV clinical trials. Major drawbacks of this product are: lack of chemical homogeneity, skin phototoxicity, unfavourable physicochemical properties and poor selectivity in terms of uptake and retention by tumour versus normal cells. Most second generation photosensitizers, including the phthalocyanines, show an increased photodynamic efficiency in the treatment of animal tumours and reduced phototoxic side effects. In 1997, there were more than half a dozen new sensitizers in or about to start clinical trials. To introduce the basic principles of photodynamic therapy, the current review article discusses in some more detail the treatment of endobronchial lung cancer, one of the leading indications of PDT. Moreover, a broad overview is given on the use of PDT for treatment of a wide variety of tumorous and nontumorous diseases, including new strategies for control of rheumatoid arthritis and application of PDT for extracorporeal bone marrow purging.
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PMID:Photodynamic therapy: the clinical perspective. Review on applications for control of diverse tumorous and non-tumorous diseases. 942 71

Photodynamic therapy utilizing Photofrin has proved to be an effective modality that can be used in the treatment of a wide variety of solid tumors and luminal cancers. The effectiveness of photodynamic therapy (PDT) was demonstrated in our institution in 1980 for the treatment of lung cancers, and increasing attention has been focused on this new treatment technique. Over the past decade, 240 patients (283 lesions) with central type lung cancers have been treated in our hospital. Overall complete remission was obtained in 39.6% of the 112 lesions, partial remission in 59.4%, and no remission was obtained in 1.0%. However, among 95 early stage lesions, CR was obtained in 79 (83.2%) and 71 cases were disease free at 3 to 176 months. We conclude that PDT is efficacious in the treatment of superficial lung cancer where complete remission may be achieved.
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PMID:Photodynamic therapy for early stage bronchogenic carcinoma. 961 88


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