1
|
Li Z, Zhang Z, Ma L, Wen H, Kang M, Li D, Zhang W, Luo S, Wang W, Zhang M, Wang D, Li H, Li X, Wang H. Combining Multiple Photosensitizer Modules into One Supramolecular System for Synergetic Enhanced Photodynamic Therapy. Angew Chem Int Ed Engl 2024; 63:e202400049. [PMID: 38193338 DOI: 10.1002/anie.202400049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/10/2024]
Abstract
Photodynamic therapy (PDT), as an emerging cancer treatment, requires the development of highly desirable photosensitizers (PSs) with integrated functional groups to achieve enhanced therapeutic efficacy. Coordination-driven self-assembly (CDSA) would provide an alternative approach for combining multiple PSs synergistically. Here, we demonstrate a simple yet powerful strategy of combining conventional chromophores (tetraphenylethylene, porphyrin, or Zn-porphyrin) with pyridinium salt PSs together through condensation reactions, followed by CDSA to construct a series of novel metallo-supramolecular PSs (S1-S3). The generation of reactive oxygen species (ROS) is dramatically enhanced by the direct combination of two different PSs, and further reinforced in the subsequent ensembles. Among all the ensembles, S2 with two porphyrin cores shows the highest ROS generation efficiency, specific interactions with lysosome, and strong emission for probing cells. Moreover, the cellular and living experiments confirm that S2 has excellent PDT efficacy, biocompatibility, and biosafety. As such, this study will enable the development of more efficient PSs with potential clinical applications.
Collapse
Affiliation(s)
- Zhikai Li
- College of Chemistry and Environmental Engineering, Shenzhen University, Shenzhen, Guangdong, 518060, China
- State Key Laboratory of Organometallic Chemistry, Shanghai Institute of Organic Chemistry, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200032, China
| | - Zhijun Zhang
- Center for AIE Research, College of Materials Science and Engineering, Shenzhen University, Shenzhen, Guangdong, 518060, China
| | - Lingzhi Ma
- State Key Laboratory for Mechanical Behavior of Materials, Shaanxi International Research Center for Soft Matter, School of Materials Science and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, China
| | - Haifei Wen
- Center for AIE Research, College of Materials Science and Engineering, Shenzhen University, Shenzhen, Guangdong, 518060, China
| | - Miaomiao Kang
- Center for AIE Research, College of Materials Science and Engineering, Shenzhen University, Shenzhen, Guangdong, 518060, China
| | - Danxia Li
- Center for AIE Research, College of Materials Science and Engineering, Shenzhen University, Shenzhen, Guangdong, 518060, China
| | - Wenjing Zhang
- Green Catalysis Center, College of Chemistry, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Siqi Luo
- College of Chemistry and Environmental Engineering, Shenzhen University, Shenzhen, Guangdong, 518060, China
| | - Weiguo Wang
- Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, Liaoning, 116023, China
| | - Mingming Zhang
- State Key Laboratory for Mechanical Behavior of Materials, Shaanxi International Research Center for Soft Matter, School of Materials Science and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, China
| | - Dong Wang
- Center for AIE Research, College of Materials Science and Engineering, Shenzhen University, Shenzhen, Guangdong, 518060, China
| | - Haiyang Li
- Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, Liaoning, 116023, China
| | - Xiaopeng Li
- College of Chemistry and Environmental Engineering, Shenzhen University, Shenzhen, Guangdong, 518060, China
- State Key Laboratory of Organometallic Chemistry, Shanghai Institute of Organic Chemistry, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200032, China
- Shenzhen University General Hospital, Shenzhen University Clinical Medical Academy, Shenzhen, Guangdong, 518055, China
| | - Heng Wang
- College of Chemistry and Environmental Engineering, Shenzhen University, Shenzhen, Guangdong, 518060, China
- State Key Laboratory of Organometallic Chemistry, Shanghai Institute of Organic Chemistry, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200032, China
| |
Collapse
|
2
|
Fernández Guarino M, Fernández-Nieto D, Montes LV, Lobo DDP. Methyl Aminolaevulinic Acid versus Aminolaevulinic Acid Photodynamic Therapy of Actinic Keratosis with Low Doses of Red-Light LED Illumination: Results of Long-Term Follow-Up. Biomedicines 2022; 10:biomedicines10123218. [PMID: 36551974 PMCID: PMC9775939 DOI: 10.3390/biomedicines10123218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/05/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
Photodynamic therapy (PDT) treatment for multiple actinic keratosis (AK) has been found effective when lower doses of red light were used with methyl aminolaevulinic acid (MAL). The aim of this study was to compare the results of lower doses of red light conventional PDT (h-PDT, 16 J/cm2) with MAL and aminolaevulinic acid (ALA) in a long-term follow-up. Patients with more than five symmetrical AK on the scalp who were candidates for PDT were selected and divided randomly between MAL and ALA treatment and patients were followed at 3 and 12 months. The responses were assessed by counting the total AK and the AK per patient. Pain and adverse events were also compiled. A total of 46 patients were treated, 24 with MAL, and 22 with ALA. The two groups were comparable at baseline (p > 0.005). No significant differences were found in the results of both treatments at 12 months, despite ALA exhibiting slightly better results at 3 months. No differences in pain and adverse events were assessed. Both ALA and MAL were effective when lower doses of red light were used in c-PDT. Long term efficacy was also documented. Further studies are necessary to determine the inferior point of red-light illumination without losing efficacy.
Collapse
|
3
|
Sjöholm A, Claeson M, Paoli J. Measurements of illuminance in simulated daylight photodynamic therapy. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2022; 38:564-570. [PMID: 35437865 PMCID: PMC9790370 DOI: 10.1111/phpp.12792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 04/08/2022] [Accepted: 04/15/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Simulated daylight photodynamic therapy (SDL-PDT) is a new treatment alternative for actinic keratosis. The aim of this study was to show how the illuminance that reaches the target skin area during SDL-PDT depends on the spatial positioning of the patient. METHODS In this technical validation study, illuminance from the SDL-PDT system IndoorLux© was measured at different angles, directions, and distances from the light sources corresponding to potential target skin areas. Using two different photometers, data from 63 measuring points at seven specific distances from the ceiling were collected at 0°, 45°, and 90° angles, respectively. Illuminance levels ≥12,000 lux were regarded as adequate. Hotspots were defined as adequate measurements in all directions at a specific measuring point at distances of 1.3, 1.5, and 1.8 m from the light sources (i.e., the most common patient treatment positions). RESULTS Adequate illuminance levels were more common with photometer 1 (73%) than photometer 2 (57%). Almost all illuminance levels were adequate at a 0° angle with both photometers. Adequate illuminance levels were observed at 82-93% of the measuring points at a 45° angle and 22-47% at a 90° angle. Hotspots were registered with both photometers at all measuring points at 0°; 59-79% of the measuring points at 45°; and 0-21% at 90°. CONCLUSION Patient positioning is important during SDL-PDT. Adequate illuminance is achieved if target skin areas are positioned at 0°-45° angles relative to the light sources, but not at 90° angles.
Collapse
Affiliation(s)
- Alexandra Sjöholm
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dermatology and Venereology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Magdalena Claeson
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dermatology and Venereology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - John Paoli
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dermatology and Venereology, Sahlgrenska University Hospital, Gothenburg, Sweden
| |
Collapse
|
4
|
Actinic keratosis (review of literature). BIOMEDICAL PHOTONICS 2022. [DOI: 10.24931/2413-9432-2022-11-1-37-48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Actinic keratosis is an important medical and social problem, the correct diagnosis and treatment of which will help to avoid the development of invasive forms of cutaneous squamous cell carcinoma. With the further development of the early diagnosis of cancer, including skin cancer, the increase in human life expectancy, and the popularization of travel to exotic countries, the number of cases of actinic keratosis among the population will continue to grow. In this regard, it is important to discuss the causes and pathogenesis of the disease, the varied clinical picture of the disease, methods of non-invasive diagnostics, as well as methods of treatment, of which there are a great many in the treatment of actinic keratosis today. However, each of the methods has both advantages and disadvantages, and in the global trend towards a personalized approach to treatment, it is important to choose from the standpoint of evidence-based medicine the most suitable for each individual patient. Moreover, after treatment of actinic keratosis, relapses often occur, which are the result of insufficient diagnosis and the development of incorrect treatment tactics. The review article provides the clinical picture of actinic keratosis, diagnostic and therapeutic methods, and their comparison with each other in terms of efficacy and safety
Collapse
|
5
|
Could Photodynamic Therapy Be a Promising Therapeutic Modality in Hepatocellular Carcinoma Patients? A Critical Review of Experimental and Clinical Studies. Cancers (Basel) 2021; 13:cancers13205176. [PMID: 34680325 PMCID: PMC8534013 DOI: 10.3390/cancers13205176] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/22/2021] [Accepted: 10/02/2021] [Indexed: 12/16/2022] Open
Abstract
Simple Summary Hepatocellular Carcinoma (HCC) is one of the leading causes of cancer-associated mortality worldwide. With a limited number of therapeutic options available and a lack of effective anti-tumoral immune responses by the therapies, there is a dire need to search for new translational treatment options. Photodynamic Therapy (PDT), in recent years, has proven itself as an effective anti-cancer therapy. In this review, we discuss the mechanism of PDT, its evolution as an anti-cancer modality, with a special focus on HCC. We also highlight the immune response generated by PDT and how it could be essential in HCC treatment. Finally, we proposed an intraoperative procedure for the treatment of HCC by combining hepatectomy with PDT. Abstract Photodynamic Therapy (PDT) relies on local or systemic administration of a light-sensitive dye, called photosensitizer, to accumulate into the target site followed by excitation with light of appropriate wavelength and fluence. This photo-activated molecule reacts with the intracellular oxygen to induce selective cytotoxicity of targeted cells by the generation of reactive oxygen species. Hepatocellular carcinoma (HCC), one of the leading causes of cancer-associated mortality worldwide, has insufficient treatment options available. In this review, we discuss the mechanism and merits of PDT along with its recent developments as an anti-cancerous therapy. We also highlight the application of this novel therapy for diagnosis, visualization, and treatment of HCC. We examine the underlying challenges, some pre-clinical and clinical studies, and possibilities of future studies associated with PDT. Finally, we discuss the mechanism of an active immune response by PDT and thereafter explored the role of PDT in the generation of anti-tumor immune response in the context of HCC, with an emphasis on checkpoint inhibitor-based immunotherapy. The objective of this review is to propose PDT as a plausible adjuvant to existing therapies for HCC, highlighting a feasible combinatorial approach for HCC treatment.
Collapse
|
6
|
A Warp-Knitted Light-Emitting Fabric-Based Device for In Vitro Photodynamic Therapy: Description, Characterization, and Application on Human Cancer Cell Lines. Cancers (Basel) 2021; 13:cancers13164109. [PMID: 34439263 PMCID: PMC8394325 DOI: 10.3390/cancers13164109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 12/17/2022] Open
Abstract
Simple Summary While photodynamic therapy appears to be a promising approach to treating cancers, the complexity of its parameters prevents wide acceptance. Accurate light dose measurement is one of the keys to photodynamic effect assessment, but it remains challenging when comparing different technologies. This work provides a complete demonstration of the technical performance of a homemade optical device, based on knitted light-emitting fabrics, called CELL-LEF. Thermal and optical distributions and related safeties are investigated. The results are discussed in relation to the requirements of photodynamic therapy. The usability of CELL-LEF is investigated on human cancer cell lines as a proof of concept. This study highlights that new light-emitting fabric-based technologies can be relevant light sources for in vitro photodynamic therapy studies of tomorrow. Abstract Photodynamic therapy (PDT) appears to be a promising strategy in biomedical applications. However, the complexity of its parameters prevents wide acceptance. This work presents and characterizes a novel optical device based on knitted light-emitting fabrics and dedicated to in vitro PDT involving low irradiance over a long illumination period. Technical characterization of this device, called CELL-LEF, is performed. A cytotoxic study of 5-ALA-mediated PDT on human cancer cell lines is provided as a proof of concept. The target of delivering an irradiance of 1 mW/cm2 over 750 cm2 is achieved (mean: 0.99 mW/cm2; standard deviation: 0.13 mW/cm2). The device can maintain a stable temperature with the mean thermal distribution of 35.1 °C (min: 30.7 °C; max: 38.4 °C). In vitro outcomes show that 5-ALA PDT using CELL-LEF consistently and effectively induced a decrease in tumor cell viability: Almost all the HepG2 cells died after 80 min of illumination, while less than 60% of U87 cell viability remained. CELL-LEF is suitable for in vitro PDT involving low irradiance over a long illumination period.
Collapse
|
7
|
Salido-Vallejo R, Jiménez-Nájar F, Garnacho-Sucedo G, Vélez A. Combined daylight and conventional photodynamic therapy with 5-aminolaevulinic acid nanoemulsion (BF-200 ALA) for actinic keratosis of the face and scalp: a new and efficient approach. Arch Dermatol Res 2019; 312:675-680. [DOI: 10.1007/s00403-019-02028-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 11/20/2019] [Accepted: 12/07/2019] [Indexed: 10/25/2022]
|
8
|
Reinehr CPH, Bakos RM. Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects. An Bras Dermatol 2019; 94:637-657. [PMID: 31789244 PMCID: PMC6939186 DOI: 10.1016/j.abd.2019.10.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 10/17/2019] [Indexed: 02/07/2023] Open
Abstract
Actinic keratoses are dysplastic proliferations of keratinocytes with potential for malignant transformation. Clinically, actinic keratoses present as macules, papules, or hyperkeratotic plaques with an erythematous background that occur on photoexposed areas. At initial stages, they may be better identified by palpation rather than by visual inspection. They may also be pigmented and show variable degrees of infiltration; when multiple they then constitute the so-called field cancerization. Their prevalence ranges from 11% to 60% in Caucasian individuals above 40 years. Ultraviolet radiation is the main factor involved in pathogenesis, but individual factors also play a role in the predisposing to lesions appearance. Diagnosis of lesions is based on clinical and dermoscopic examination, but in some situations histopathological analysis may be necessary. The risk of transformation into squamous cell carcinoma is the major concern regarding actinic keratoses. Therapeutic modalities for actinic keratoses include topical medications, and ablative and surgical methods; the best treatment option should always be individualized according to the patient.
Collapse
Affiliation(s)
| | - Renato Marchiori Bakos
- Department of Dermatology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| |
Collapse
|
9
|
O'Mahoney P, Khazova M, Eadie E, Ibbotson S. Measuring Daylight: A Review of Dosimetry in Daylight Photodynamic Therapy. Pharmaceuticals (Basel) 2019; 12:E143. [PMID: 31547141 PMCID: PMC6958468 DOI: 10.3390/ph12040143] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/05/2019] [Accepted: 09/17/2019] [Indexed: 01/28/2023] Open
Abstract
Successful daylight photodynamic therapy (DPDT) relies on the interaction of light, photosensitisers and oxygen. Therefore, the 'dose' of light that a patient receives during treatment is a clinically relevant quantity, with a minimum dose for effective treatment recommended in the literature. However, there are many different light measurement methods used in the published literature, which may lead to confusion surrounding reliable and traceable dose measurement in DPDT, and what the most appropriate method of light measurement in DPDT might be. Furthermore, for the majority of practitioners who do not carry out any formal dosimetry and for the patients receiving DPDT, building confidence in the evidence supporting this important treatment option is of key importance. This review seeks to clarify the methodology of DPDT and discusses the literature relating to DPDT dosimetry.
Collapse
Affiliation(s)
- Paul O'Mahoney
- Photobiology Unit, NHS Tayside, Ninewells Hospital, Dundee DD1 9SY, UK.
- The Scottish Photodynamic Therapy Centre, Dundee DD1 9SY, UK.
- School of Medicine, University of Dundee, Dundee DD1 9SY, UK.
| | | | - Ewan Eadie
- Photobiology Unit, NHS Tayside, Ninewells Hospital, Dundee DD1 9SY, UK.
- The Scottish Photodynamic Therapy Centre, Dundee DD1 9SY, UK.
| | - Sally Ibbotson
- Photobiology Unit, NHS Tayside, Ninewells Hospital, Dundee DD1 9SY, UK.
- The Scottish Photodynamic Therapy Centre, Dundee DD1 9SY, UK.
- School of Medicine, University of Dundee, Dundee DD1 9SY, UK.
| |
Collapse
|
10
|
Huang A, Nguyen JK, Austin E, Mamalis A, Jagdeo J. Updates on Treatment Approaches for Cutaneous Field Cancerization. CURRENT DERMATOLOGY REPORTS 2019; 8:122-132. [PMID: 31475077 DOI: 10.1007/s13671-019-00265-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Purpose of Review Field cancerization describes the phenomenon that multiple heterogenous mutations may arise in an area exposed to chronic carcinogenic stimuli. Advances in the understanding of cutaneous field cancerization have led to novel therapeutic approaches to the management of actinic keratoses (AKs). Herein, we review the literature on the pathophysiology and emerging research of field cancerization in dermatology. Recent Findings The classification systems for grading AK lesions are being refined with investigations focusing on their clinical utility. There is a growing shift towards field-directed treatment for AKs as the importance of field cancerization becomes clearer. Current field-directed therapies are being optimized and novel therapeutic modalities are being studied. Summary Field cancerization underlies the transformation of photodamaged skin into AKs and potentially cutaneous SCC (cSCC). Clinically meaningful classification systems for AKs are needed to better inform decisions regarding treatment. As we learn more about the role of field characterization in photodamage, AKs and cSCCs, therapeutic strategies are becoming more field-directed rather than lesion-directed.
Collapse
Affiliation(s)
- Alisen Huang
- Department of Dermatology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Julie K Nguyen
- Department of Dermatology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Evan Austin
- Department of Dermatology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Andrew Mamalis
- Department of Dermatology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Jared Jagdeo
- Department of Dermatology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| |
Collapse
|
11
|
Vignion-Dewalle AS, Abi Rached H, Thecua E, Lecomte F, Deleporte P, Béhal H, Hommel T, Duhamel A, Szeimies RM, Mortier L, Mordon S. A New Light-Emitting, Fabric-Based Device for Photodynamic Therapy of Actinic Keratosis: Protocol for a Randomized, Controlled, Multicenter, Intra-Individual, Phase II Noninferiority Study (the Phosistos Study). JMIR Res Protoc 2019; 8:e12990. [PMID: 31025953 PMCID: PMC6658310 DOI: 10.2196/12990] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/04/2019] [Accepted: 02/07/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Actinic keratosis (AK) is a common early in situ skin carcinoma caused by long-term sun exposure and usually develops on sun-exposed skin areas. Left untreated, AK may progress to squamous cell carcinoma. To prevent such risk, most clinicians routinely treat AK. Therapy options for AK include cryotherapy, topical treatments, curettage, excision surgery, and photodynamic therapy (PDT). OBJECTIVE The aim of this study is to assess the noninferiority, in terms of efficacy at 3 months, of a PDT protocol involving a new light-emitting device (PDT using the Phosistos protocol [P-PDT]) compared with the conventional protocol (PDT using the conventional protocol [C-PDT]) in the treatment of AK. METHODS In this randomized, controlled, multicenter, intra-individual, phase II noninferiority clinical study, subjects with AK of the forehead and scalp are treated with P-PDT on one area and with C-PDT on the contralateral area. In both areas, lesions are prepared and methyl aminolevulinate (MAL) is applied. Thirty minutes after MAL application, the P-PDT area is exposed to red light at low irradiance (1.3 mW/cm2) for 2.5 hours so that a light dose of 12 J/cm2 is achieved. In the control area (C-PDT area), a 37 J/cm2 red light irradiation is performed 3 hours after MAL application. Recurrent AK at 3 months is retreated. The primary end point is the lesion complete response rate at 3 months. Secondary end points include pain scores at 1 day, local tolerance at 7 days, lesion complete response rate at 6 months, cosmetic outcome at 3 and 6 months, and patient-reported quality of life and satisfaction throughout the study. A total of 45 patients needs to be recruited. RESULTS Clinical investigations are complete: 46 patients were treated with P-PDT on one area (n=285 AK) and with C-PDT on the contralateral area (n=285 AK). Data analysis is ongoing, and statistical results will be available in the first half of 2019. CONCLUSIONS In case of noninferiority in efficacy and superiority in tolerability of P-PDT compared with C-PDT, P-PDT could become the treatment of choice for AK. TRIAL REGISTRATION ClinicalTrials.gov NCT03076892; https://clinicaltrials.gov/ct2/show/NCT03076892 (Archived by WebCite at http://www.webcitation.org/779qqVKek). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/12990.
Collapse
Affiliation(s)
- Anne-Sophie Vignion-Dewalle
- U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Université de Lille, INSERM, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Henry Abi Rached
- U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Université de Lille, INSERM, Centre Hospitalier Universitaire de Lille, Lille, France.,Department of Dermatology, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Elise Thecua
- U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Université de Lille, INSERM, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Fabienne Lecomte
- U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Université de Lille, INSERM, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Pascal Deleporte
- U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Université de Lille, INSERM, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Hélène Béhal
- EA 2694 - Santé Publique: épidémiologie et qualité des soins, Unité de Biostatistiques, Université de Lille, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Theresa Hommel
- Department of Dermatology and Allergology, Klinikum Vest GmbH, Recklinghausen, Germany
| | - Alain Duhamel
- EA 2694 - Santé Publique: épidémiologie et qualité des soins, Unité de Biostatistiques, Université de Lille, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Rolf-Markus Szeimies
- Department of Dermatology and Allergology, Klinikum Vest GmbH, Recklinghausen, Germany
| | - Laurent Mortier
- U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Université de Lille, INSERM, Centre Hospitalier Universitaire de Lille, Lille, France.,Department of Dermatology, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Serge Mordon
- U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Université de Lille, INSERM, Centre Hospitalier Universitaire de Lille, Lille, France
| |
Collapse
|
12
|
Fernández-Guarino M, Fonda Pascual P, Lizuain Gomez P, Harto Castaño A, Jaén Olasolo P. Split-face study comparing conventional MAL photodynamic therapy in multiple actinic keratosis with complete time vs. half-time red light LED conventional illumination. J Eur Acad Dermatol Venereol 2019; 33:1529-1534. [PMID: 30868672 DOI: 10.1111/jdv.15566] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 02/25/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Conventional photodynamic therapy (PDT) with methylaminolevulinic acid (MAL) and daylight PDT have demonstrated similar efficacy in the treatment of actinic keratosis (AK). The reason for the use of daylight is to reduce pain during illumination but daylight has the limitation of the weather conditions. The difference in the doses of red light applied between these two methods suggests that an intermediate dose with red light conventional illumination could be effective in PDT of AK. OBJECTIVE To compare the efficiency of conventional MAL-PDT with half-time conventional red light illumination in patients with multiple AK. MATERIAL AND METHODS Adult patients with more than five symmetrically distributed AK were selected. After randomization, one area was treated with conventional PDT (Aktilite® , 630 nm, 37 J/cm2 , 8 min), while the contralateral was illuminated half time (Aktilite® , 630 nm, 37 J/cm2 , 4 min). Patients evaluated pain in each different side. Patients were evaluated at baseline, 3 and 6 months after PDT treatment by a blinded dermatologist. A questionnaire to be done at home 24 h after completing treatment was deliver to the patients to evaluate any side-effects. RESULTS A total of 774 lesions were treated, 385 with conventional PDT and 389 with half-time PDT (P > 0.05). Conventional PDT was 85% of complete response of AK (327/385) at 3 months, and half-time PDT was 82% (319/389). At 6 months, conventional PDT was 70% (268/385) of complete response and half-time PDT was 65% (252/389). Pain during illumination was significantly lower in the VAS with the half-time protocol with a mean of 5.59 (SD 1.48) vs. 6.41 (SD 1.66) in conventional PDT. No difference in adverse effects was found between protocols. CONCLUSION Conventional PDT with half-time illumination in multiple actinic keratosis is as effective as complete time illumination and decreased pain significantly.
Collapse
Affiliation(s)
| | - P Fonda Pascual
- Dermatology Department, Hospital Ramón y Cajal, Madrid, Spain
| | - P Lizuain Gomez
- Dermatology Department, Hospital Ramón y Cajal, Madrid, Spain
| | - A Harto Castaño
- Dermatology Department, Hospital Ramón y Cajal, Madrid, Spain
| | - P Jaén Olasolo
- Dermatology Department, Hospital Ramón y Cajal, Madrid, Spain
| |
Collapse
|
13
|
Vicentini C, Vignion-Dewalle AS, Thecua E, Lecomte F, Béhal H, Maire C, Tylcz JB, Abi-Rached H, Mortier L, Mordon S. Photodynamic therapy for actinic keratosis of the forehead and scalp with the Aktilite CL 128: Is there a cut-off value for PpIX-weighted irradiance for effective treatment? PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2019; 35:232-237. [DOI: 10.1111/phpp.12457] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 01/22/2019] [Accepted: 02/10/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Claire Vicentini
- Univ. Lille, INSERM, CHU Lille; U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology; Lille France
- Department of Dermatology; CHU Lille; Lille France
| | | | - Elise Thecua
- Univ. Lille, INSERM, CHU Lille; U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology; Lille France
| | - Fabienne Lecomte
- Univ. Lille, INSERM, CHU Lille; U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology; Lille France
| | - Hélène Béhal
- Univ. Lille, CHU Lille; EA 2694 - Santé Publique: épidémiologie et qualité des soins; Unité de Biostatistiques; Lille France
| | - Cyril Maire
- Univ. Lille, INSERM, CHU Lille; U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology; Lille France
- Department of Dermatology; CHU Lille; Lille France
| | - Jean-Baptiste Tylcz
- Univ. Lille, INSERM, CHU Lille; U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology; Lille France
| | - Henry Abi-Rached
- Univ. Lille, INSERM, CHU Lille; U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology; Lille France
- Department of Dermatology; CHU Lille; Lille France
| | - Laurent Mortier
- Univ. Lille, INSERM, CHU Lille; U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology; Lille France
- Department of Dermatology; CHU Lille; Lille France
| | - Serge Mordon
- Univ. Lille, INSERM, CHU Lille; U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology; Lille France
| |
Collapse
|