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Photodynamic Therapy pp 165–184Cite as

Photodynamic Diagnosis and Therapy for Brain Malignancies from the Bench to Clinical Application

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Abstract

Glioblastomas are the third most common cause of cancer death in patients between 15 and 35 years. Photodynamic diagnosis (PDD), fluorescence guided tumour resection (FGR) and photodynamic therapy (PDT) is undergoing intensive clinical investigations as adjuvant treatment for malignant brain tumours. Besides many reports on clinical phase I/II trials for PDT for malignant brain tumours, there are only few controlled clinical trials. Variations in treatment protocols make the evaluation scientifically difficult; however, there is a clear trend towards prolonging median survival after one single photo dynamic treatment as compared to standard therapeutic regiments. According to a met-analysis the median survival for primary glioblastoma multi-forme WHO IV after PDT was 22 months and for recurrent GBM 9 months as compared to standard conventional treatment which is 15 and 3 months, respectively. Fluorescence-guided resection of the tumour demonstrated significant greater reduction of tumour burden. The combination of PDD/FGR and intra operative PDT (“to see and to treat”) offers an exciting approach to the treatment of malignant brain tumours. Photodynamic treatment supported by observational studies with combined total of > 1,000 patients and 3 controlled trials in GBMs. PDT was highly selective, safe, significantly improved good quality survival and delayed tumour relapse (p < 0.001). The following chapter provides an overview on the current clinical data of PDT as well as photosensitisers, technical developments and indications for photodynamic application in neurosurgery.

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  1. Department of Neurosurgery, University Innsbruck, Innsbruck, Austria

    Herwig Kostron

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Correspondence to Herwig Kostron .

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  1. German University of Cairo, New Cairo City, Egypt

    Mahmoud H. Abdel-Kader

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Kostron, H. (2014). Photodynamic Diagnosis and Therapy for Brain Malignancies from the Bench to Clinical Application. In: Abdel-Kader, M. (eds) Photodynamic Therapy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-39629-8_8

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