Systemic photodynamic therapy with photosensitizer photolon in the treatment of cancer patients with regional and distant metastases

The results of photodynamic therapy (PDT) in 76 patients with tumors of different sites and with regional or distant metastases are represented. Sixty three patients were under combined or multimodal therapy, 13 patients had systemic PDT as monotherapy. The technique of PDT was as follows: the solution of photosensitizer photolon was administered intravenously at dose of 0.8–1.4 mg/ kg body weight. Laser blood irradiation was performed simultaneously (wavelength of 662 nm, output power of 20 mW, irradiation time of 50 min). Stabilization of the disease defined as the absence of new tumor foci was observed in 55% of treated patients: among them in 47% of patients with disseminated melanoma during 6–10 months after treatment, in 65% patients with breast cancer – for 3–6 years after treatment, and also in 100% of patients with cancer of other sites (colorectal, pancreatic, cervical, ovarian, lung and stomach cancer, retroperitoneal neuroblastoma) – for 10–12 months after treatment. According to ultrasound data the shrinkage of most of metastases up to its complete disappearance was observed. The authors consider that effects of systemic PDT are due to decrease of circulating tumor cells in blood and also due to beneficial impact of this modal of treatment on immune status of cancer patient. Intravenous PDT was shown to improve treatment results and quality of life in patients with metastases of malignant tumors. The approved technique is of considerable interest and requires further investigation of its efficiency including its combination with methods of combined and multimodal treatment.

1. Grekh I.F. Vazhneishie faktory vozniknoveniya i razvitiya retsidivov i metastazov zlokachestvennykh opukholei. Metastazirovanie zlokachestvennykh opukholei (Crucial factors of relapses and metastasis of malignant tumors), L.: Meditsina, 1971, pp. 7–90.

2. Evens A.M., Bitran J.D. Adjuvant chemotherapy, The Chemotherapy source book, 3d ed., edit. by M. Perry, Lippincott Willims & Wilkins, 2001, pp. 48–69.

3. Klein C.A., Holzel D. Systemic cancer progression and tumor dormancy, Cell Cycle, 2006, Vol. 5, № 16, pp. 1788–98.

4. Pantel K., Cote R.J., Fodstadt O. Detection and clinical importance of micrometastatic disease, J. Nat.Cancer Inst., 1999, Vol. 91, pp. 1113–24.

5. Chissov V.I., Starinskii V.V., Petrova G.V. Sostoyanie onkologicheskoi pomoshchi naseleniyu Rossii v 2008 g. (Status of cancer care for Russian population), M.: FGU «MNIOI im. P.A. Gertsena», 2009, pp. 1–192.

6. Vasil'ev N.E., Sysoeva G.M., Danilenko E.D. Immunologicheskie aspekty fotodinamicheskoi terapii (Immunological aspects of photodynamic therapy), Meditsinskaya immunologiya, 2003, T. 5, №. 5–6, pp. 507–18.

7. Evans S., Matthews W., Perry R. et al. Effect of photodynamic therapy on tumor necrosis factor production by murine macrophages, J. Natl. Cancer Inst., 1990, Vol. 82, pp. 34–9.

8. Henderson B.W., Donovan J.M. Cellular prostaglandin E release after photodynamic therapy, Lasers Med. Sci., 1988, Vol. 3, p. 103.

9. Hart I.R. Metastasis. Oxford textbook of oncology. 2nd ed. Edit. By R. Souhami, I. Tannock, P. Hohenberger, J.C. Horiot. Oxford University Press, 2002, pp. 102–13.

10. Luksiene Z. Photodynamic therapy: mechanism of action and ways to improve the efficiency of treatment, J. Medicina, 2003, Vol. 39, No. 12, pp. 1137–47.

11. Dougherty T.J., Gomer C.J., Henderson B.W., Jori G., Kessel D., Korbelik M., Moan J., Peng Q. Photodynamic therapy, J. Natl. Cancer Inst., 1998, Vol. 90, pp. 889–905.

12. Flint D.H., Tuminello J.E., Emptage M.H. The inactivation of Fe-S cluster containing hydro-lyases by superoxide, J. Biol. Chem., 1993, Vol. 268, pp. 22369–76.

13. Krasnovskij A.A. Fotosensibilizirovannaja fosforescencija singletnogo molekuljarnogo kisloroda: metody izmerenija i primenenie k analizu fotodestruktivnyh processov v kletkah (Photosensitized singlet molecular oxygen phosphorescence: methods of measurement and use for analysis of photodestructive processes in cells), Uspehi biologicheskoj himii, 1999, T. 39, pp. 255–88.

14. Girotti A.W. Lipid hydroperoxide generation, turnover, and effector action in biological systems, J. Lip. Res., 1998, Vol. 39 (8), pp. 1529–42.

15. Klebanov G.I., Strashkevich I.V., Chichuk T.V., Modestova T.M., Vladimirov Yu.A. Vliyanie endogennykh fotosensibilizatorov na lazer-indutsirovannyi praiming leikotsitov krovi (Impact of endogenic photosensitizers on laser-induced priming of blood leukocytes), Biol. Membrany, 1998, T. 15, № 3, pp. 273–85.

16. Klebanov G.I., Vladimirov Yu.A. Kletochnye mekhanizmy praiminga i aktivatsii fagotsitov (Cellular mechanisms of priming and activation of phagocytes), Uspekhi sovremennoi biologii, 1999, T. 119, № 5, pp. 462–75.

17. Klebanov G.I., Teselkin Yu.O., Babenkova I.V., Bashkueva T.Yu., Modestova T.M., Steklova L.S., Vladimirov Yu.A. Vliyanie nizkointensivnogo lazernogo izlucheniya na funktsional'nyi potentsial leikotsitov (Impact of low-intensity laser irradiation on functional capacity of leucocytes), Byull. Eksp. Biol. med., 1997, T. 123, № 4, pp. 395–8.

18. Laptev V.P., Kiselevskii M.I., Ovchinnikov A.E. i dr. Vliyanie FDT s ispol'zovaniem preparata Khlorina-e6 na zhiznesposobnost' i funktsional'nuyu aktivnost' limfotsitov perifericheskoi krovi (Impact of PDT with Chlorine-e6 on viability and functional activity of peripheral blood lymphocytes ), Fizicheskaya meditsina, 2005, T. 15, № 2, pp. 46–7.

19. Pass Kh.I. Fotodinamicheskaya terapiya v onkologii: mekhanizmy i klinicheskoe primenenie (Photodynamic therapy in oncology: mechanisms and clinical use), Fizicheskaya meditsina, 1993, T. 3, № 3–4, pp. 5–22.

20. Gel'fond M.L. Barchuk A.S. Predvaritel'nye rezul'taty khimiosensibilizirovannoi fotomodifikatsii krovi s preparatom «Fotoditazin» pri rasprostranennykh zlokachestvennykh novoobrazovaniyakh razlichnoi lokalizatsii (Preliminary results of chemosensitized photomodification of blood with Fotoditazin for advanced malignant neoplasms of different sites), Rossiiskii bioterapevticheskii zhurnal, 2005, T. 4, № 1, pp. 33–4.

21. Fingar V. Vascular effect of photodynamic therapy, J. Clin. Laser Med. Surg., 1996, Vol. 14, pp. 323-8.