ORIGINAL ARTICLES
This work is dedicated to the study of the photoluminescence kinetics of aluminum phthalocyanine nanoparticles in colloidal solutions at different pH and in the interaction with immune cells (macrophages). For measurements we used a registration system based on Hamamatsu streak camera (C10627-13 Hamamatsu Photonics) with picosecond temporal resolution (15 ps), conjugated with the fiberoptic spectrometer and picosecond laser pumping. The changes in fluorescence decay kinetics as additional lifetime components of fluorescence were found during the experiment. The number of components and duration of lifetimes changed while interacting with cells and depends on pH. At pH 2 the presence of two fluorescence lifetimes was recorded: the first one was 5 ns, which corresponded to the molecular form in solution, and 1.5 ns, which corresponded to bound state of phthalocyanine molecules. Due to the absence of other possible objects for bounding in the solution except of the nanoparticles we can suggest with a high degree of accuracy that the bounding occurs with the very these nanoparticles. Analysis of the fluorescence lifetimes of aluminum phthalocyanine nanoparticles in macrophages indicated the presence of two components: 9 ns and 4.5 ns. A model of surface molecules transitions from parallel to perpendicular position, regarding to the plane of the crystal nanoparticle was proposed.
The original method of intraoperative photodynamic therapy for multimodality treatment of primary and recurrent breast cancer for devitalization of malifnant cells at wound surface and for prevention of further cancer dissemination was developed in P.A. Herzen Moscow Cancer Research Institute. The developed method was approved in 79 patients with locally advanced breast cancer stage IIB and IIIA,B,C with poor prognostic factors. For photodynamic therapy the photosensitizer photosens (30 min intravenous infusion at dose of 0.3 mg/kg of body weight 2 h before surgery) was used in 56 patients; alasens (solution in 100 ml of still drinking water, orally at dose of 30 mg/kg of body weight 2 h before general anesthesia) — in 23 patients. The surgical field was irradiated on a single occasion: the dose of laser irradiation on the bed of removed primary or recurrent tumor was 20–30 J/cm2, in the removed regional lymph nodes area – 50 J/cm2. Long-term results of the treatment were assessed in 34 patients: there were no disease progression in 50% of patients, 14.7% of patients had locoregional recurrence, distant metastases were in 35.3% of patients. The level of photosensitizer accumulation in tissue was additionally analyzed in 26 patients by fluorescence intensity in tumor and in normal breast tissue. After injection of alasens the increase in level of alasens-induced protoporphyrin IX fluorescence was recorded in tumor (the average diagnostic parameter was 6.5 a.u.) and in intact breast tissue (an average of 0.47 a.u.), tumor/normal tissue fluorescence contrast varied from 3 to 33. The level of protoporphyrin IX accumulation was noticed to be lower in tumors with pathomorphological response after neoadjuvant therapy. For photosens value of the average diagnostic parameter in normal breast tissue was 5.6 a.u., in tumor – 34.3 a.u., tumor/normal tissue fluorescence contrast – from 2 to 9.
The new method of photodynamic therapy for basal cell skin carcinoma with intralesional injection of photolon (at dose of 1.44-2.50 mg/cm3 of tumor volume 15 min before irradiation) was developed in the department of dermatology, venerology and dermatooncology in The State Budgetary Healthcare Institution of Moscow Area Moscows regional research clinical institute n.a. M.F. Vladimirskiy. The efficacy of the developed method was evaluated in clinical studies in 30 patients comparing with the group of 32 patients who had conventional PDT with typical intravenous injection of photolon (at dose of 2.0–2.5 mg/kg of body weight 3 h before irradiation). The characteristics of irradiation were the same both in the study and in the control groups: power density of 0.31-0.47 W/cm2, light dose of 300 J/cm2. Compared PDT regimens had similar efficiency. As a result of the performed treatment complete tumor regression was achieved in 93.3% patients with intralesional injection of photolon and in 90.6% patients with intravenous injection. The rate of patients with 2-year recurrence-free survival after intralesional injection of photolon accounted for 96.7%; after intravenous injection – 93.8%. However, the developed method demonstrated superior safety comparing with intravenous injection of photolon: such as there was no need for light regimen after intralesional injection of photolon, there were no cases of skin phototoxicity (12.5% for intravenous injection), no increasing of transaminases (37.5% for intravenous injection).
LITERATURE REVIEWS
Characteristics of diagnosis and treatment of different types of primary vaginal cancer are highlighted, the role and place of brachytherapy as independent method or combined treatment modality for this pathology is shown in the review. Epidemiological data on incidence of vaginal cancer in Russia are represented, presumptive mechanisms for development of the disease, risk factors, histological types, features of the course, clinical presentation, diagnostic algorithm are described. Treatment methods for primary vaginal cancer according to world standards such as surgery, radiotherapy and systemic drug therapy are covered. Specifics of radiological methods of treatment (low-dose rate and high-dose rate brachytherapy, including the combination with external beam radiotherapy) according to the stage of the disease, are shown in details. The results of several large foreign clinical trials for efficiency of different methods of radiotherapy are discussed. The combination of brachytherapy on primary tumor with external radiation therapy to the lymph nodes was confirmed to be the most effective modality. The conclusion on opportunities of different methods of radiotherapy in treatment of vaginal cancer was made.