5-10-15-20-tetrakis(m-hydroxyphenyl)bacteriochlorin and Liver-Neoplasms

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.

Topics: Adult; Aged; Colorectal Neoplasms; Female; Humans; Infusions, Intravenous; Laser Therapy; Liver Neoplasms; Male; Middle Aged; Photochemotherapy; Porphyrins; Skin

Development and evaluation of a new photodynamic treatment technique for the laser therapy of liver malignancies. 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 contrast-enhanced CT scans.. 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.. 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.

Topics: Aged; Colorectal Neoplasms; Female; Hematoporphyrin Photoradiation; Humans; Image Enhancement; Injections, Intralesional; Liver; Liver Neoplasms; Male; Middle Aged; Necrosis; Porphyrins; Tomography, X-Ray Computed

Locoregional treatments like photodynamic therapy (PDT), radiofrequency ablation (RFA) or hepatic artery infusion (HAI) of chemotherapeutics may be applied for unresectable colorectal liver metastases. We evaluated the effect of these treatments on the immune response in a rat colon tumour liver metastases model.. Wag/Rij rats were inoculated at day 0 with CC531 tumour cells at two sites in the liver. At day 15, one of two tumours was treated with RFA or PDT, or the liver was treated by HAI. Twelve days later (day 27), rats were rechallenged locally with CC531 cells in the liver or systemically with CC531 cells in the femoral vein. At day 42, tumour growth in liver and lungs was determined.. RFA, PDT and HAI were very effective in liver tumour eradication, but following RFA or PDT there was no inhibitory effect on untreated nearby liver tumours. Outgrowth after local rechallenge was, however, significantly inhibited in RFA-, PDT- and HAI-treated rats, whereas all control rats showed outgrowth of a third liver tumour. After systemic rechallenge, control rats developed lung metastases whereas treated rats did not, but this difference was not statistically significant.. These results show that following PDT, RFA and HAI resistance to local and possibly systemic tumour rechallenge is increased. This may be partly due to the induction or enhancement of a cellular immune response.

Topics: Animals; Antibodies; Catheter Ablation; Colonic Neoplasms; Disease Models, Animal; Disease Progression; Infusion Pumps, Implantable; Liver Neoplasms; Male; Melphalan; Neoplasm Metastasis; Photochemotherapy; Porphyrins; Rats; Rats, Inbred Strains