The applications of multispectral autofluorescence imaging of malignant tumor was shown in in vitro and in vivo experiments. Using ТС-1 mouse tumor model it was demonstrated that the location of tumor formation can be clearly identified as early as 2 days after injection of tumor cells. Among observed effects the new one is an unusually active angiogenesis at early stage of tumor formation accompanied by atypical tortuous vessels with growth rate up to 3 mm/day. Two-wave excitation simultaneous laser with excitation on wavelength of 390 nm and 635 nm is shown to be promising for autofluorescence diagnosis along with single-wave excitation which is conventionally performed in the violet-blue region of the spectrum. This mode of excitation allows detecting the increased level of protoporphyrin IX even at early stage of carcinogenesis. The fluorescence due to active synthesis of protoporphyrin IX was shown to correlate with density of vessels. Increase of this fluorescence is observed also for aseptic inflammation but it has diffuse pattern which allows differentiating it from local fluorescence image at the site of tumor formation. The possibility of successful achievement of high-quality image using multispectral imaging and also optimization of registration settings were demonstrated in the experiment. The study of surgical specimen showed capabilities of imaging and measurement of autofluorescence in tumor tissue. The obtained results are intended to help in the development of endoscopic methods of imaging and devices for diagnosis of early tumors.

The results of treatment in patients with skin cancer using the method of photodynamic therapy (PDT) with alasens are represented in the article. The study enrolled 25 patients with stage 1 tumor including 23 patients with previously untreated tumors and 2 – with recurrent disease. Superficial tumor was diagnosed in 17 patients and 8 patients had nodal tumor. Alasens was used locally as application of 20% ointment on involved skin area with 6h exposure. The PDT session was performed on a single occasion immediately after the end of exposure (power density of laser irradiation of 50–100 mW/cm², light dose – 150–200 J/cm²). All patients had fluorescence diagnosis (FD) prior to application of the ointment and before PDT. The results of FD showed that intensity of porphyrin fluorescence in tumor prior to administration of alasens had near no difference from intensity of porphyrin fluorescence in normal skin (12.5±0.7 and 10.0±0.7 r.u., respectively). Six hours after application of the ointment with alasens the fluorescence intensity of protoporphyrin IX increased almost 5-fold (59.7±5.3 r.u.), the fluorescence intensity in normal skin remained near baseline level during the follow-up period (maximally 11.6±1.0 r.u.). Two months after PDT the complete tumor regression was confirmed in 21 patients, partial – in 3 and stabilization of tumor growth in 1 patient. In addition, patients with superficial disease had complete regression in 94.1% of cases and partial regression in 5.9% while for patients with nodal tumor – 62.5% and 25%, respectively, stabilization – in 12.5%.

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.

The results of multicenter prospective trial for efficacy of combined modality treatment: transurethral resection (TUR) + photodynamic therapy (PDT) with alasens for bladder cancer are represented in the article. Trials were organized by Research Institute of Organic Intermediates and Dyes and conducted according to clinical protocol approved by Ministry of Health of Russia, at the sites of leading Russian cancer clinical centers. The trial included 45 subjects with verified diagnosis of non-muscle-invasive bladder cancer. Patients underwent TUR of bladder with simultaneous PDT as anti-relapse treatment. Alasens was administered to patients as intravesicular instillation of 3% solution in volume of 50 ml with 1.5–2h exposure (prior to TUR). TUR was performed after instillation. PDT session was conducted immediately after the completion of TUR on a single occasion by means of combined local irradiation on tumor bed with diffuse irradiation on whole urinary bladder mucosa (light dose of local irradiation – 100 J/cm2, diffuse irradiation – 20 J/cm²). Good tolerance of the treatment was noticed, there were no complications. Among 45 patients included in the trial, 35 (78%) completed 12 month protocol follow-up without relapse. The recurrence of bladder tumor was registered in 10 (22%) cases 6–12 months after TUR+PDT including 3 patients with recurrence 6 months after treatment, 3–9 months and 4–12 months. These patients underwent repeated TUR, whereafter their follow-up in the settings of the clinical trial was disposed. Thus, PDT with alasens after TUR allowed to decrease the recurrence rate of non-muscle-invasive bladder cancer for 1st year after treatment to 22% versus 40–80% for TUR as monotherapy according to literature data. The obtained results were comparable by efficiency with TUR combined with methods of adjuvant treatment for bladder tumors (the recurrence rates for 1-year follow-up after TUR+chemotherapy – 36–44%, after TUR+BCG – 20–59%).

A case of successful photodynamic therapy (PDT) of the patient with grade 3 vulvar dysplasia. One course of treatment with photolon was performed. The photosensitizer was administered intravenously as 30 min infusion in dose of 1.0 mg/kg body weight. The PDT session was performed 3h after infusion of photolon, the light dose was 350 J/cm². The treatment was well tolerated. Due to PDT a complete tumor regression was achieved. The patient received a strict follow-up schedule, for 8 months after PDT no recurrence was observed.