Hi Stephen, hi all,
i read good things about the photodynamix therapy, for example:
https://www.ncbi.nlm.nih.gov/pubmed/25915500
One question about that topic does not let me go: Would it be possible to use that technique after a "full resection" or as an conservation thearapy when there is no tumor visible?
Don`t you think you could attack left over cells that way?
Thank you for an response!
All good!
In any study of photodynamic therapy I've ever read, the photosensitizer was give just prior to surgery, and then the laser light is applied during the surgery after tumor resection while the brain is still exposed. In other words this is a process that is done during a tumor surgery, not afterwards.
ReplyDeleteIn my opinion, they should be using photodyamic therapy for brain tumors wherever 5-ALA based fluorescent guided surgery is practised, but they don't.
There was a clinical trial testing this in France (now closed)
https://clinicaltrials.gov/ct2/show/NCT03048240
and one supposed to open soon for newly diagnosed GBM in Germany
https://clinicaltrials.gov/ct2/show/NCT03897491
There have been trials in Wisconsin in the USA using a first generation photosensitizer (Photofrin) but I believe these are now closed.
Other than clinical trials, I'm not aware of many clinics using this technique for brain tumors. I'm a fan of the technique myself.
And in answer to your question, yes I think PDT would be valuable even after a total tumor resection, to help destroy the cells that are inevitably left behind following gross resection.
ReplyDeleteI am presently living in Japan, and I can tell you that Japan appears significantly more advanced in this area in my opinion. PDT is already approved for insurance cover here, and is commonly provided at least at the more glioma specialized hospitals. The survival statistics appear incredibly favorable (e.g. Tokyo Women's Medical University >30 months OS in their GBM patient base), but obviously this is not a controlled study population. I spoke to the doctors there, and it is basically side effect free except some temporary light sensitivity following surgery.
ReplyDeleteI should note the technique used in Japan is Talaporfin Sodium based, so different than what seems to be commonly trialed in the West.
Best,
John
Please see for example this study for reference:
Deletehttps://www.researchgate.net/publication/331376217_Role_of_photodynamic_therapy_using_talaporfin_sodium_and_a_semiconductor_laser_in_patients_with_newly_diagnosed_glioblastoma
By the way, I also asked the doctor in Japan about the possibility to get a PDT treatment without confirmed recurrence, and he affirmed that this is indeed possible. However, he advised me that it would be better not to do it without urgent need as any additional surgery would be inherently risky.
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