5-aminolevulinic-acid-hexyl-ester and Adenocarcinoma

A homogeneous illumination of intra-abdominal organs is essential for successful photodynamic therapy of the abdominal cavity. Considering the current lack of outstanding light-delivery systems, a new illumination procedure was assessed. A rat model of peritoneal carcinomatosis was used. Four hours after intraperitoneal injection of hexaminolevulinate, a square illuminating panel connected to a 635-nm laser source was inserted vertically into the abdominal cavity. The abdominal incision was sutured and a pneumoperitoneum created prior to illumination. Light dosimetry was based on the calculation of the peritoneal surface by MRI. The rats were treated with a light dose of 20, 10, 5 or 2.5 J/cm(2) administered continuously with an irradiance of 7 mW/cm(2). The homogeneity of the cavity illumination was assessed by quantification of the photobleaching of the tumor lesions according to their localization and by scoring of that of the liver and of the bowel immediately after treatment. Photobleaching quantification for tumor lesions relied on the calculation of the fluorescence intensity ratio (after/before treatment) after recording of the lesions during blue-light laparoscopy and determination of their fluorescence intensity with Sigmascan Pro software. The procedure led to a homogeneous treatment of the abdominal cavity. No statistical difference was observed for the photobleaching values according to the localization of the lesions on the peritoneum (p=0.59) and photobleaching of the liver and of the intestine was homogeneous. We conclude that this procedure can successfully treat the major sites involved in peritoneal carcinomatosis.

Topics: Abdominal Cavity; Adenocarcinoma; Aminolevulinic Acid; Animals; Cell Line, Tumor; Female; Intestines; Liver; Magnetic Resonance Imaging; Ovarian Neoplasms; Peritoneal Neoplasms; Photochemotherapy; Photosensitizing Agents; Radiometry; Rats; Rats, Inbred F344; Spectrometry, Fluorescence; Statistics, Nonparametric

Photodynamic therapy has been developed as an alternative therapy of cancer. The aim of this study was to examine whether PDT with hexenyl ester of 5-aminolaevulinic acid (ALA-hx) inhibits the proliferation of the salivary gland adenocarcinoma SGT cells. Cell proliferation was examined by MTT assay. The gene expression of Coproporphyrinogen oxidase (CPO) and ROS production was also examined. Flow cytometry and in vivo Chorioallantoic membrane (CAM) assay was performed. ALA-hx PDT inhibited effectively the proliferation of SGT cells. Treatment of ALA-hx induced CPO mRNA expression and ROS was produced by ALA-hx PDT in SGT cells. Flow cytometry and LDH assay showed that ALA-hx PDT induced necrotic cell death rather than apoptosis in SGT cells. In vivo CAM assay showed that ALA-hx PDT induced tumor destruction by inducing necrosis. These results indicate that ALA-hx PDT effectively inhibits the proliferation of SGT cells by inducing necrosis.

Topics: Adenocarcinoma; Aminolevulinic Acid; Animals; Antineoplastic Agents; Cell Death; Cell Line, Tumor; Cell Survival; Chick Embryo; Coproporphyrinogen Oxidase; Gene Expression Regulation, Enzymologic; Gene Expression Regulation, Neoplastic; Humans; Necrosis; Neoplasm Invasiveness; Photochemotherapy; Reactive Oxygen Species; Salivary Gland Neoplasms

This experimental study aimed to compare three illumination schemes to optimize hexaminolaevulinate (HAL)-PDT in a rat tumor model with advanced ovarian cancer.. Peritoneal carcinomatosis was induced by intraperitoneal 5×10(6)NuTu-19 cells injection in 60 female rats Fisher 344. Carcinomatosis was obtained 50 days post-tumor induction. Four hours post-intraperitoneal HAL (Photocure ASA, Oslo, Norway) injection, three different schemes of PDT were performed during 25 min on a 1cm(2) area. (A) Fractionated illumination (n=20) with an on-off cycle ("on": 2 min and "off": 1 min) at 30mW cm(-2) until a fluence of 30J cm(-2), (B) continuous illumination (n=20) at 30mW cm(-2) with a fluence of (45J cm(-2)C) continuous illumination (n=20) at 20mW cm(-2) with a fluence of 30J cm(-2). Laser light was generated using a 532nm KTP laser (Laser Quantum, Stockport, UK). Biopsies were taken 24h after treatment. Quantitative histology was performed. Necrosis value was determined: 0-no necrosis to 4-full necrosis. Depth of necrosis was then measured for each sample and correlated to Necrosis value.. HAL-PDT was efficient in producing necrosis irrespective of the scheme. Tumor destruction was superior with fractionated illumination compared to both continuous illumination schemes regarding to the depth of necrosis (213±113μm vs 154±133μm vs 171±155μm) (p<0.05) or to the full necrosis rate (50% vs 30% vs 10%) (p<0.0001).. Fractionated illumination during photodynamic therapy (PDT) was shown to improve tumor response. Fractionated illumination with short intervals should be considered for an effective PDT of advanced ovarian cancer.

Topics: Adenocarcinoma; Aminolevulinic Acid; Animals; Disease Models, Animal; Female; Ovarian Neoplasms; Peritoneal Neoplasms; Photochemotherapy; Photosensitizing Agents; Rats; Rats, Inbred F344

Accurate dosimetry was shown to be critical to achieve effective photodynamic therapy (PDT). This study aimed to assess the reliability of in vivo protoporphyrin IX (PpIX) fluorescence photobleaching as a predictive tool of the hexaminolevulinate PDT (HAL-PDT) response in a rat model of advanced ovarian cancer.. Intraperitoneal 10(6) NuTu 19 cells were injected in 26 female rats Fisher 344. Peritoneal carcinomatosis was obtained 26 days post-tumor induction. Four hours post-intraperitoneal HAL (Photocure ASA, Oslo, Norway) injection, a laparoscopic procedure (D-light AutoFluorescence system, Karl Storz endoscope, Tuttlingen, Germany) and a fluorescence examination were made for 22 rats. The first group (LASER group, n=26) was illuminated with laser light using a 532 nm KTP laser (Laser Quantum, Stockport, UK) on 1 cm(2) surface at 45 J/cm(2). The second group (NO LASER group, n=26) served as controls. Biopsies were taken 24 hours after PDT. Semi-quantitative histology was performed and necrosis value was determined: 0--no necrosis to 4--full necrosis. Fluorescence was monitored before and after illumination on complete responders (NV=3-4; n=20) and non-responders (NV=0-2; n=6).. High PpIX photobleaching corresponded with complete responders whereas low photobleaching corresponded with non-responders (P<0.05). A direct linear correlation was shown between photobleaching and necrosis (R(2)=0.89).. In vivo PpIX fluorescence photobleaching is useful to predict the tissue response to HAL-PDT.

Topics: Adenocarcinoma; Aminolevulinic Acid; Animals; Female; Microscopy, Fluorescence; Ovarian Neoplasms; Photobleaching; Photochemotherapy; Photosensitizing Agents; Predictive Value of Tests; Protoporphyrins; Rats; Rats, Inbred F344; Reproducibility of Results