Photodynamic Therapy With 5,10,15,20-Tetrakis(m-Hydroxyphenyl) Bacteriochlorin for Colorectal Liver Metastases Is Safe and Feasible: Results From a Phase I Study
- 159 Downloads
The prognosis for patients with liver metastases from colorectal carcinoma is limited because of the low number of patients who are eligible for curative hepatic resection. In this phase I study, 31 liver metastases in 24 patients with nonresectable metastases from colorectal carcinoma were treated with photodynamic therapy (PDT).
The photosensitizer 5,10,15,20-tetrakis(m-hydroxyphenyl)bacteriochlorin (mTHPBC) was intravenously administered in a dose of .6 mg/kg (n = 12) or .3 mg/kg (n = 12). After 120 hours (n = 18) or 48 hours (n = 6), tumors were illuminated for 300 to 600 seconds through percutaneously inserted optical fibers with a light dose of 60 J/cm of diffuser (740 nm).
Tumor necrosis at 1 month after PDT was achieved in all treated lesions. Laser treatment was associated with mild pain (n = 8) and transient subclinical hepatotoxicity (n = 21). In one patient, PDT damage to the pancreas was inflicted, and in another patient, PDT damage of the skin occurred, but no serious clinical complications from PDT were reported. Administration of .6 mg/kg of mTHPBC led to transient phlebitis in 10 patients, and 3 patients experienced mild skin phototoxicity after excess light exposure.
Colorectal liver metastases that are ineligible for resection can be safely and effectively treated with interstitial mTHPBC-based PDT.
KeywordsPhotodynamic therapy Liver metastases Colorectal cancer Phase I.
- 11.Purkiss SF, Dean R, Allardice JT, Grahn MF, Williams NS. An interstitial light delivery system for photodynamic therapy within the liver. Lasers Med Sci 1993;8:253–7Google Scholar
- 12.Purkiss SF, Grahn MF, Abulafi AM, Dean R, Allardice JT, Williams NS. Multiple fiber interstitial photodynamic therapy of patients with colorectal liver metastases. Lasers Med Sci 1994;9:27–35Google Scholar
- 21.Goldberg SN, Charboneau JW, Dodd GD III, et al. Image-guided tumor ablation: proposal for standardization of terms and reporting criteria. Radiology 2003;228:335–45Google Scholar
- 27.Curley SA. Radiofrequency ablation of malignant liver tumors. Ann Surg Oncol 2003;10:338–47Google Scholar
- 28.Solbiati L, Goldberg SN, Ierace T, et al. Hepatic metastases: percutaneous radio-frequency ablation with cooled-tip electrodes. Radiology 1997;205:367–73Google Scholar