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Subramanian Karthikesh M, Martinez-Rivera N, Rosa-Molinar E, Wang X, Yang X. Ultrasound-assisted laser therapy for selective removal of melanoma cells. Exp Biol Med (Maywood) 2024; 249:10096. [PMID: 39170033 PMCID: PMC11338193 DOI: 10.3389/ebm.2024.10096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 07/26/2024] [Indexed: 08/23/2024] Open
Abstract
The current study explores the potential of ultrasound-assisted laser therapy (USaLT) to selectively destroy melanoma cells. The technology was tested on an ex vivo melanoma model, which was established by growing melanoma cells in chicken breast tissue. Ultrasound-only and laser-only treatments were used as control groups. USaLT was able to effectively destroy melanoma cells and selectively remove 66.41% of melanoma cells in the ex vivo tumor model when an ultrasound peak negative pressure of 2 MPa was concurrently applied with a laser fluence of 28 mJ/cm2 at 532 nm optical wavelength for 5 min. The therapeutic efficiency was further improved with the use of a higher laser fluence, and the treatment depth was improved to 3.5 mm with the use of 1,064 nm laser light at a fluence of 150 mJ/cm2. None of the laser-only and ultrasound-only treatments were able to remove any melanoma cells. The treatment outcome was validated with histological analyses and photoacoustic imaging. This study opens the possibility of USaLT for melanoma that is currently treated by laser therapy, but at a much lower laser fluence level, hence improving the safety potential of laser therapy.
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Affiliation(s)
- Madhumithra Subramanian Karthikesh
- Bioengineering Graduate Program, University of Kansas, Lawrence, KS, United States
- Institute for Bioengineering Research, University of Kansas, Lawrence, KS, United States
| | - Noraida Martinez-Rivera
- Microscopy and Analytical Imaging Laboratory, University of Kansas, Lawrence, KS, United States
| | - Eduardo Rosa-Molinar
- Bioengineering Graduate Program, University of Kansas, Lawrence, KS, United States
- Microscopy and Analytical Imaging Laboratory, University of Kansas, Lawrence, KS, United States
- Department of Pharmacology and Toxicology, and Neuroscience, University of Kansas, Lawrence, KS, United States
| | - Xueding Wang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Xinmai Yang
- Bioengineering Graduate Program, University of Kansas, Lawrence, KS, United States
- Institute for Bioengineering Research, University of Kansas, Lawrence, KS, United States
- Department of Mechanical Engineering, School of Engineering, University of Kansas, Lawrence, KS, United States
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Rolfe OJ, Stark AL, Hamilton HR, D'Mellow M, Palmer JM, McGrath LA, Warrier SK, Glasson WJ. Combined photodynamic therapy and transpupillary thermotherapy for small choroidal melanoma. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024:S0008-4182(24)00034-6. [PMID: 38431268 DOI: 10.1016/j.jcjo.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/03/2023] [Accepted: 02/05/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE The objective of this study was to determine whether combining verteporfin-based photodynamic therapy (PDT) and transpupillary thermotherapy (TTT) achieves adequate tumour control while maintaining visual acuity in individuals with small choroidal melanoma of amelanotic, melanotic, and variable pigmentation. DESIGN Individuals with posterior choroidal melanomas up to 3 mm in height underwent verteporfin-based PDT followed by immediate TTT. Further combined laser therapy was performed if a poor response was noted at 12 weeks or beyond. Tumours that demonstrated significant further growth were treated with brachytherapy or enucleation. A total of 37 eyes of 37 patients from the Terrace Eye Centre in Brisbane, Australia were studied. Average age of participants was 59.62 ± 12.45 years, and 17 of 37 participants were female (46%). METHODS This was a retrospective, noncomparative interventional study. RESULTS Seven of the 37 participants (19%) had recurrence of their tumour requiring further brachytherapy or enucleation. There was no statistically significant difference in visual acuity before and after treatment. There were no baseline characteristics that predicted treatment outcome. Ten individuals developed complications including epiretinal membrane (16%), scotoma (8%), cataract (3%), and macular edema (3%). No individuals experienced extraocular extension or progressed to metastatic disease. The mean follow-up time was 49 months. CONCLUSION Combined PDT and TTT achieved 81% tumour control in this study while preserving visual acuity. However, higher rates of local recurrence compared with brachytherapy warrant close follow-up to identify recurrences early.
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Affiliation(s)
- Olivia J Rolfe
- Queensland Ocular Oncology Service, Terrace Eye Centre, Brisbane, QLD, Australia.
| | - Andrew L Stark
- Queensland Ocular Oncology Service, Terrace Eye Centre, Brisbane, QLD, Australia
| | - Hayley R Hamilton
- Queensland Ocular Oncology Service, Terrace Eye Centre, Brisbane, QLD, Australia; QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Matthew D'Mellow
- Queensland Ocular Oncology Service, Terrace Eye Centre, Brisbane, QLD, Australia; QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Jane M Palmer
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Lindsay A McGrath
- Queensland Ocular Oncology Service, Terrace Eye Centre, Brisbane, QLD, Australia
| | - Sunil K Warrier
- Queensland Ocular Oncology Service, Terrace Eye Centre, Brisbane, QLD, Australia
| | - William J Glasson
- Queensland Ocular Oncology Service, Terrace Eye Centre, Brisbane, QLD, Australia
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Sinenko IL, Kuttler F, Simeonov V, Moulin A, Aouad P, Stathopoulos C, Munier FL, Berger A, Dyson PJ. Translational screening platform to evaluate chemotherapy in combination with focal therapy for retinoblastoma. Cancer Sci 2023; 114:3728-3739. [PMID: 37340597 PMCID: PMC10475790 DOI: 10.1111/cas.15878] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/15/2023] [Accepted: 05/20/2023] [Indexed: 06/22/2023] Open
Abstract
Retinoblastoma is the most common pediatric eye cancer. It is currently treated with a limited number of drugs, adapted from other pediatric cancer treatments. Drug toxicity and relapse of the disease warrant new therapeutic strategies for these young patients. In this study, we developed a robust tumoroid-based platform to test chemotherapeutic agents in combination with focal therapy (thermotherapy) - a treatment option widely used in clinical practice - in accordance with clinically relevant trial protocols. The model consists of matrix-embedded tumoroids that retain retinoblastoma features and respond to repeated chemotherapeutic drug exposure similarly to advanced clinical cases. Moreover, the screening platform includes a diode laser (810 nm, 0.3 W) to selectively heat the tumoroids, combined with an on-line system to monitor the intratumoral and surrounding temperatures. This allows the reproduction of the clinical settings of thermotherapy and combined chemothermotherapy treatments. When testing the two main drugs currently used in clinics to treat retinoblastoma in our model, we observed results similar to those clinically obtained, validating the utility of the model. This screening platform is the first system to accurately reproduce clinically relevant treatment methods and should lead to the identification of more efficient drugs to treat retinoblastoma.
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Affiliation(s)
- Irina L. Sinenko
- Institute of Chemical Sciences and EngineeringÉcole Polytechnique Fédérale de Lausanne (EPFL)LausanneSwitzerland
- Ophthalmology DepartmentUniversity of Lausanne, Jules‐Gonin Eye Hospital, Fondation Asile des AveuglesLausanneSwitzerland
| | - Fabien Kuttler
- Biomolecular Screening Facility, School of Life SciencesÉcole Polytechnique Fédérale de Lausanne (EPFL)LausanneSwitzerland
| | - Valentin Simeonov
- Laboratory of Environmental Remote SensingÉcole Polytechnique Fédérale de Lausanne (EPFL)LausanneSwitzerland
| | - Alexandre Moulin
- Ophthalmology DepartmentUniversity of Lausanne, Jules‐Gonin Eye Hospital, Fondation Asile des AveuglesLausanneSwitzerland
| | - Patrick Aouad
- Ophthalmology DepartmentUniversity of Lausanne, Jules‐Gonin Eye Hospital, Fondation Asile des AveuglesLausanneSwitzerland
| | - Christina Stathopoulos
- Ophthalmology DepartmentUniversity of Lausanne, Jules‐Gonin Eye Hospital, Fondation Asile des AveuglesLausanneSwitzerland
| | - Francis L. Munier
- Ophthalmology DepartmentUniversity of Lausanne, Jules‐Gonin Eye Hospital, Fondation Asile des AveuglesLausanneSwitzerland
| | - Adeline Berger
- Ophthalmology DepartmentUniversity of Lausanne, Jules‐Gonin Eye Hospital, Fondation Asile des AveuglesLausanneSwitzerland
| | - Paul J. Dyson
- Institute of Chemical Sciences and EngineeringÉcole Polytechnique Fédérale de Lausanne (EPFL)LausanneSwitzerland
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Laser treatment for choroidal melanoma: Current concepts. Surv Ophthalmol 2023; 68:211-224. [PMID: 35644256 DOI: 10.1016/j.survophthal.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 05/16/2022] [Accepted: 05/23/2022] [Indexed: 12/14/2022]
Abstract
Laser treatment has offered a relatively nonsurgical alternative for eye, life, and vision-sparing treatment of malignant melanoma of the choroid. Historically, the most commonly used forms of lasers were xenon-arc, argon laser, krypton laser, and the more recent transpupillary thermotherapy (TTT) and photodynamic therapy (PDT). Melanomas selected for laser treatment tend to be smaller and visibly accessible, which means these tumors are usually located in the posterior choroid. Laser treatments have been associated with both local tumor destruction and side effects. Unlike radiation therapy, laser treatment has been commonly associated with retinal traction, hemorrhage, chorioretinal neovascularization, and extra scleral tumor extension, as well as higher rates of local treatment failure. In addition, however, laser-treatment has been successfully used to treat tumor-related retinal detachments, radiation retinopathy, and neovascular glaucoma. We review the world's experience of ophthalmic laser treatment for choroidal melanoma, offer safety and efficacy guidelines, as well as a comparison of laser treatment to radiation therapy outcomes.
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Shen J, Gao H, Chen L, Jiang Y, Li S, Chao Y, Liu N, Wang Y, Wei T, Liu Y, Li J, Chen M, Zhu J, Liang J, Zhou X, Zhang X, Gu P, Chen Q, Liu Z. Eyedrop-based macromolecular ophthalmic drug delivery for ocular fundus disease treatment. SCIENCE ADVANCES 2023; 9:eabq3104. [PMID: 36706184 PMCID: PMC9882978 DOI: 10.1126/sciadv.abq3104] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 12/27/2022] [Indexed: 06/18/2023]
Abstract
Therapeutic antibodies are extensively used to treat fundus diseases by intravitreal injection, as eyedrop formulation has been rather challenging due to the presence of ocular barriers. Here, an innovative penetrating carrier was developed for antibody delivery in eyedrop formulations. We found that fluorocarbon-modified chitosan (FCS) would self-assemble with proteins to form nanocomplexes, which could effectively pass across the complicated ocular structure to reach the posterior eye segments in both mice and rabbits. In a choroidal melanoma-bearing mouse model, eyedrops containing FCS/anti-PDL1 could induce stronger antitumor immune responses than those triggered by intravenous injection of anti-PDL1. Moreover, in choroidal neovascularization-bearing mouse and rabbit models, FCS/anti-VEGFA eyedrops effectively inhibited vascular proliferation, achieving comparable therapeutic responses to those observed with intravitreal injection of anti-VEGFA. Our work presents an effective delivery carrier to treat fundus diseases using eyedrop of therapeutic proteins, which may enable at-home treatment of many eye diseases with great patient compliance.
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Affiliation(s)
- Jingjing Shen
- Institute of Functional Nano and Soft Materials (FUNSOM), Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices, Soochow University, Suzhou 215123, China
| | - Huiqin Gao
- Department of Ophthalmology, Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, P. R. China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, P. R. China
| | - Linfu Chen
- Institute of Functional Nano and Soft Materials (FUNSOM), Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices, Soochow University, Suzhou 215123, China
| | - Yutong Jiang
- Institute of Functional Nano and Soft Materials (FUNSOM), Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices, Soochow University, Suzhou 215123, China
| | - Shu Li
- Department of Ophthalmology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, 215123 China
| | - Yu Chao
- Institute of Functional Nano and Soft Materials (FUNSOM), Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices, Soochow University, Suzhou 215123, China
| | - Nanhui Liu
- Institute of Functional Nano and Soft Materials (FUNSOM), Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices, Soochow University, Suzhou 215123, China
| | - Yufei Wang
- Institute of Functional Nano and Soft Materials (FUNSOM), Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices, Soochow University, Suzhou 215123, China
| | - Ting Wei
- Institute of Functional Nano and Soft Materials (FUNSOM), Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices, Soochow University, Suzhou 215123, China
| | - Yan Liu
- Department of Ophthalmology, Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, P. R. China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, P. R. China
| | - Jipeng Li
- Department of Ophthalmology, Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, P. R. China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, P. R. China
| | - Muchao Chen
- Institute of Functional Nano and Soft Materials (FUNSOM), Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices, Soochow University, Suzhou 215123, China
| | - Jiafei Zhu
- Institute of Functional Nano and Soft Materials (FUNSOM), Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices, Soochow University, Suzhou 215123, China
| | - Juan Liang
- Department of Ophthalmology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, 215123 China
| | - Xiaoyu Zhou
- Department of Ophthalmology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, 215123 China
| | - Xiaofeng Zhang
- Department of Ophthalmology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, 215123 China
| | - Ping Gu
- Department of Ophthalmology, Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, P. R. China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, P. R. China
| | - Qian Chen
- Institute of Functional Nano and Soft Materials (FUNSOM), Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices, Soochow University, Suzhou 215123, China
| | - Zhuang Liu
- Institute of Functional Nano and Soft Materials (FUNSOM), Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices, Soochow University, Suzhou 215123, China
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Thomas CD, Lupu M, Poyer F, Maillard P, Mispelter J. Increased PDT Efficacy When Associated with Nitroglycerin: A Study on Retinoblastoma Xenografted on Mice. Pharmaceuticals (Basel) 2022; 15:ph15080985. [PMID: 36015132 PMCID: PMC9415823 DOI: 10.3390/ph15080985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/02/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
Purposes: The aim of the study was to assess the efficacy of a treatment protocol that combines photodynamic therapy (PDT) and nitroglycerin (NG) on human retinoblastoma tumors xenografted on mice. We aimed to increase the PDT efficiency (in our least treatment-responsive retinoblastoma line) with better PS delivery to the tumor generated by NG, which is known to dilate vessels and enhance the permeability and retention of macromolecules in solid tumors. Methods: In vivo follow-up of the therapeutic effects was performed by sodium MRI, which directly monitors variations in sodium concentrations non-invasively and can be used to track the tumor response to therapy. NG ointment was applied one hour before PDT. The PDT protocol involves double-tumor targeting, i.e., cellular and vascular. The first PS dose was injected followed by a second one, separated by a 3 h interval. The timelapse allowed the PS molecules to penetrate tumor cells. Ten minutes after the second dose, the PS was red-light-activated. Results: In this study, we observed that the PDT effect was enhanced by applying nitroglycerin ointment to the tumor-bearing animal’s skin. PDT initiates the bystander effect on retinoblastomas, and NG increases this effect by increasing the intratumoral concentration of PS, which induces a higher production of ROS in the illuminated region and thus increases the propagation of the cell death signal deeper into the tumor (bystander effect).
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Affiliation(s)
- Carole D. Thomas
- Institut Curie, Bât. 112, Centre Universitaire, 91405 Orsay, France
- U1288 INSERM, LITO Laboratoire d’Imagerie Translationnelle en Oncologie, Bât. 101B, Centre Universitaire, 91405 Orsay, France
- Université Paris-Sud, 91405 Orsay, France
- Correspondence: ; Tel.: +33-(0)1-69-86-71-97
| | - Mihaela Lupu
- Institut Curie, Bât. 112, Centre Universitaire, 91405 Orsay, France
- Université Paris-Sud, 91405 Orsay, France
- U1196 INSERM, Bât. 112, Centre Universitaire, 91405 Orsay, France
- UMR 9187 CNRS, Bât. 112, Centre Universitaire, 91405 Orsay, France
| | - Florent Poyer
- Institut Curie, Bât. 112, Centre Universitaire, 91405 Orsay, France
- Université Paris-Sud, 91405 Orsay, France
- U1196 INSERM, Bât. 112, Centre Universitaire, 91405 Orsay, France
- UMR 9187 CNRS, Bât. 112, Centre Universitaire, 91405 Orsay, France
| | - Philippe Maillard
- Institut Curie, Bât. 112, Centre Universitaire, 91405 Orsay, France
- Université Paris-Sud, 91405 Orsay, France
- U1196 INSERM, Bât. 112, Centre Universitaire, 91405 Orsay, France
- UMR 9187 CNRS, Bât. 112, Centre Universitaire, 91405 Orsay, France
| | - Joël Mispelter
- Institut Curie, Bât. 112, Centre Universitaire, 91405 Orsay, France
- Université Paris-Sud, 91405 Orsay, France
- U1196 INSERM, Bât. 112, Centre Universitaire, 91405 Orsay, France
- UMR 9187 CNRS, Bât. 112, Centre Universitaire, 91405 Orsay, France
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de Brito RV, Mancini MW, Palumbo MDN, de Moraes LHO, Rodrigues GJ, Cervantes O, Sercarz JA, Paiva MB. The Rationale for "Laser-Induced Thermal Therapy (LITT) and Intratumoral Cisplatin" Approach for Cancer Treatment. Int J Mol Sci 2022; 23:5934. [PMID: 35682611 PMCID: PMC9180481 DOI: 10.3390/ijms23115934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 01/27/2023] Open
Abstract
Cisplatin is one of the most widely used anticancer drugs in the treatment of various types of solid human cancers, as well as germ cell tumors, sarcomas, and lymphomas. Strong evidence from research has demonstrated higher efficacy of a combination of cisplatin and derivatives, together with hyperthermia and light, in overcoming drug resistance and improving tumoricidal efficacy. It is well known that the antioncogenic potential of CDDP is markedly enhanced by hyperthermia compared to drug treatment alone. However, more recently, accelerators of high energy particles, such as synchrotrons, have been used to produce powerful and monochromatizable radiation to induce an Auger electron cascade in cis-platinum molecules. This is the concept that makes photoactivation of cis-platinum theoretically possible. Both heat and light increase cisplatin anticancer activity via multiple mechanisms, generating DNA lesions by interacting with purine bases in DNA followed by activation of several signal transduction pathways which finally lead to apoptosis. For the past twenty-seven years, our group has developed infrared photo-thermal activation of cisplatin for cancer treatment from bench to bedside. The future development of photoactivatable prodrugs of platinum-based agents injected intratumorally will increase selectivity, lower toxicity and increase efficacy of this important class of antitumor drugs, particularly when treating tumors accessible to laser-based fiber-optic devices, as in head and neck cancer. In this article, the mechanistic rationale of combined intratumor injections of cisplatin and laser-induced thermal therapy (CDDP-LITT) and the clinical application of such minimally invasive treatment for cancer are reviewed.
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Affiliation(s)
- Renan Vieira de Brito
- Department of Otolaryngology and Head and Neck Surgery, Federal University of São Paulo (UNIFESP), Sao Paulo 04023-062, SP, Brazil; (R.V.d.B.); (M.d.N.P.); (O.C.)
| | - Marília Wellichan Mancini
- Biophotonics Department, Institute of Research and Education in the Health Area (NUPEN), Sao Carlos 13562-030, SP, Brazil;
| | - Marcel das Neves Palumbo
- Department of Otolaryngology and Head and Neck Surgery, Federal University of São Paulo (UNIFESP), Sao Paulo 04023-062, SP, Brazil; (R.V.d.B.); (M.d.N.P.); (O.C.)
| | - Luis Henrique Oliveira de Moraes
- Department of Physiological Sciences, Federal University of Sao Carlos (UFSCar), Sao Carlos 13565-905, SP, Brazil; (L.H.O.d.M.); (G.J.R.)
| | - Gerson Jhonatan Rodrigues
- Department of Physiological Sciences, Federal University of Sao Carlos (UFSCar), Sao Carlos 13565-905, SP, Brazil; (L.H.O.d.M.); (G.J.R.)
| | - Onivaldo Cervantes
- Department of Otolaryngology and Head and Neck Surgery, Federal University of São Paulo (UNIFESP), Sao Paulo 04023-062, SP, Brazil; (R.V.d.B.); (M.d.N.P.); (O.C.)
| | - Joel Avram Sercarz
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA;
| | - Marcos Bandiera Paiva
- Department of Otolaryngology and Head and Neck Surgery, Federal University of São Paulo (UNIFESP), Sao Paulo 04023-062, SP, Brazil; (R.V.d.B.); (M.d.N.P.); (O.C.)
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA;
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Guerra Guimarães T, Menezes Cardoso K, Tralhão P, Marto CM, Alexandre N, Botelho MF, Laranjo M. Current Therapeutics and Future Perspectives to Ocular Melanocytic Neoplasms in Dogs and Cats. Bioengineering (Basel) 2021; 8:bioengineering8120225. [PMID: 34940378 PMCID: PMC8698280 DOI: 10.3390/bioengineering8120225] [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: 11/29/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 12/24/2022] Open
Abstract
Neoplasms of melanocytic origin are diseases relevant to dogs and cats' ophthalmic oncology due to their incidence, potential visual loss, and consequent decrease in life quality and expectancy. Despite its non-specific clinical presentation, melanocytic neoplasms can be histologically distinguished in melanocytomas, which present benign characteristics, and malignant melanomas. The diagnosis often occurs in advanced cases, limiting the therapeutic options. Surgery, cryotherapy, radiotherapy, photodynamic therapy (PDT), and laser are currently available therapeutic strategies. As no clinical guidelines are available, the treatment choice is primarily based on the clinician's preference, proficiency, and the owner's financial constraints. While surgery is curative in benign lesions, ocular melanomas present a variable response to treatments, besides the potential of tumour recurrences or metastatic disease. This review presents the currently available therapies for ocular melanocytic neoplasms in dogs and cats, describing the therapeutic, indications, and limitations. Additionally, new therapeutics being developed are presented and discussed, as they can improve the current treatment options.
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Affiliation(s)
- Tarcísio Guerra Guimarães
- Institute of Research and Advanced Training (IIFA), University of Évora, 7002-554 Évora, Portugal; (T.G.G.); (K.M.C.)
- Mediterranean Institute for Agriculture, Environment and Development (MED), University of Évora, 7006-554 Évora, Portugal;
- Institute of Biophysics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; (C.M.M.); (M.F.B.)
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Karla Menezes Cardoso
- Institute of Research and Advanced Training (IIFA), University of Évora, 7002-554 Évora, Portugal; (T.G.G.); (K.M.C.)
- Mediterranean Institute for Agriculture, Environment and Development (MED), University of Évora, 7006-554 Évora, Portugal;
- Institute of Biophysics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; (C.M.M.); (M.F.B.)
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Pedro Tralhão
- Center of Veterinary Ophthalmology, Oftalvet, 4050-102 Porto, Portugal;
| | - Carlos Miguel Marto
- Institute of Biophysics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; (C.M.M.); (M.F.B.)
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
- Institute of Experimental Pathology, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
| | - Nuno Alexandre
- Mediterranean Institute for Agriculture, Environment and Development (MED), University of Évora, 7006-554 Évora, Portugal;
- Department of Veterinary Medicine, University of Évora, 7004-516 Évora, Portugal
| | - Maria Filomena Botelho
- Institute of Biophysics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; (C.M.M.); (M.F.B.)
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
| | - Mafalda Laranjo
- Institute of Biophysics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; (C.M.M.); (M.F.B.)
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
- Correspondence:
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Saigal K, El Hamichi S, Gold AS, Murray TG. Case Report: Two Genetically Distinct Choroidal Melanomas in the Same Eye Treated with Endolaser Therapy. Optom Vis Sci 2021; 98:1011-1015. [PMID: 34433203 DOI: 10.1097/opx.0000000000001769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE This case report highlights the merits of using fine needle aspiration biopsy to obtain gene expression profiling of individual choroidal melanomas when more than one tumor arises in the same eye. It is also the first such case to document laser ablation therapy as the primary treatment. PURPOSE This report describes a case of two primary choroidal melanomas with different genetic profiles in the same eye. CASE REPORT An 80-year-old man presented to the office with a neoplasm of uncertain behavior in the left eye. The patient's visual acuity and IOP in the left eye, respectively, at the time of his first visit to the office were 20/25 and 8 mmHg. A dilated fundus examination revealed that there were two choroidal lesions in the left eye. The macular lesion was classified as type 1A, and the ciliochoroidal lesion was classified as type 1B. The patient underwent a vitrectomy of the left eye, followed by endolaser ablation of the tumors. The patient was also injected with bevacizumab. To date, the patient is free of known metastasis. Most recently, his visual acuity and IOP in the left eye were 20/30 and 14 mmHg, respectively. CONCLUSIONS Although rare, multiple melanomas in the same eye may have differing genetic profiles, which may alter prognosis and management, depending on the class of tumor detected.
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Affiliation(s)
| | | | - Aaron S Gold
- Murray Ocular Oncology and Retina, Miami, Florida
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10
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Abstract
A retrospective analysis of the immediate and long-term effectiveness of the treatment of the choroidal melanoma using transpupillary thermotherapy (TTT) was carried out. The study included 84 patients with choroidal melanoma (C69.3) who received treatment between 2007 and 2018. Patients were sampled from the Belarusian Cancer Register. The average values of the thickness of the tumor were 2.6±1.3 mm, the diameter of the base - 7.2±3.3 mm. TTT was carried out using a diode laser with a wavelength of 860 nm and radiation power of 200 - 800 mW, the exposure time was 60 s, and the diameter of the laser spot was varied between 1 and 3 mm. The entire surface of the tumor was thermally treated with overlapping fields from the periphery to the top. 75 patients underwent a single session of TTT, while 9 - two sessions with an interval of 3–4 weeks. As a result of the treatment, 51 (60.7%) patients showed complete tumor resorption, 28 (33.3%) patients had stabilization of the tumor process, and 5 (6.0%) patients had no effect. In the group of patients with stabilization of the tumor process, continued growth was recorded in 16 (19.1%) patients with follow-up periods of 3 months to 4 years. In 19 (37.3%) patients from the group with complete tumor regression, relapse was observed 1 to 8 years after TTT. Metastatic disease (disease progression) developed in 5 (5.9%) patients, of which in 1 patient during the first 12 months, in 1 patient - after 4 years, and in 3 patients more than after 5 years of the follow-up observation. Analysis of the effectiveness of TTT of choroidal melanoma showed that an increase in the thickness and diameter of the base of the tumor focus results in the decrease of immediate effectiveness, and the rise of the likelihood of continued tumor growth.
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Liu L, Hu C, Chen L, Hu Y. Photodynamic therapy for symptomatic circumscribed choroidal hemangioma in 22 Chinese patients: A retrospective study. Photodiagnosis Photodyn Ther 2018; 24:372-376. [PMID: 30381258 DOI: 10.1016/j.pdpdt.2018.10.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 10/25/2018] [Accepted: 10/26/2018] [Indexed: 11/27/2022]
Abstract
The purpose of this study is to describe the effects and complications of photodynamic therapy (PDT) on Chinese patients with circumscribed choroidal hemangioma (CCH). In this retrospective study, 22 CCH patients who underwent PDT performed 15 min after the injection of intravenous verteporfin (6 mg/m2)with multiple 83-second laser spots at 689 nm (50 J/cm2) were studied. Fluorescein angiography and/or indocyanine green angiography, B-scan ultrasonography and optical coherence tomography were performed in all patients. Follow-up was performed until 12 months post-treatment. All patients were treated with one session, except 1 case with prior transpupillary thermotherapy history. At the 12-month follow-up, the mean of the best corrected visual acuity (BCVA) increased from 0.40 ± 0.38 to 0.56 ± 0.42 (p < 0.05), tumors became thinner (1.96 ± 2.65 mm vs. 4.31 ± 2.04 mm) (p < 0.05), and exudative detachment were diminished. The mean fovea center thickness (FCT) decreased from 540.1 ± 470.6 to 171.6 ± 79.3 μm at the 3-month follow-up. The 12-month BCVA was correlated with prior laser treatment, symptom duration, baseline CCH diameter and thickness, baseline FCT and cystoid macular edema. One patient developed a branch retinal artery occlusion. In conclusion, PDT is an effective and safe treatment for CCH. Specific PDT protocols for CCH should be standardized. The retinal arteriole should be spared during the treatment.
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Affiliation(s)
- Limin Liu
- Department of Ophthalmology, the First Affiliated Hospital of China Medical University. No. 155 Nanjing Bei Street, Heping District, Shenyang City, Liaoning Province, 110001, People's Republic of China
| | - Chunmei Hu
- Department of Ophthalmology, Tacheng area people's Hospital, No. 22, Wenhua road Tacheng City, the Xinjiang Uygur Autonomous Region, People's Republic of China
| | - Lei Chen
- Department of Ophthalmology, the First Affiliated Hospital of China Medical University. No. 155 Nanjing Bei Street, Heping District, Shenyang City, Liaoning Province, 110001, People's Republic of China; Diabetic Eye Center of Liaoning province. No. 155 Nanjing Bei Street, Heping District, Shenyang City, Liaoning Province, 110001, People's Republic of China; The Key Laboratory of Endocrine diseases in Liaoning Province, The First Hospital of China Medical University, No. 155 Nanjing Bei Street, Heping District, Shenyang City, Liaoning Province, 110001, People's Republic of China
| | - Yuedong Hu
- Department of Ophthalmology, the First Affiliated Hospital of China Medical University. No. 155 Nanjing Bei Street, Heping District, Shenyang City, Liaoning Province, 110001, People's Republic of China; Department of Ophthalmology, Tacheng area people's Hospital, No. 22, Wenhua road Tacheng City, the Xinjiang Uygur Autonomous Region, People's Republic of China; Diabetic Eye Center of Liaoning province. No. 155 Nanjing Bei Street, Heping District, Shenyang City, Liaoning Province, 110001, People's Republic of China; The Key Laboratory of Endocrine diseases in Liaoning Province, The First Hospital of China Medical University, No. 155 Nanjing Bei Street, Heping District, Shenyang City, Liaoning Province, 110001, People's Republic of China.
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Soliman SE, VandenHoven C, Mackeen LD, Gallie BL. Vision and visual potential for perifoveal retinoblastoma after optical coherence tomographic-guided sequential laser photocoagulation. Br J Ophthalmol 2018; 103:753-760. [PMID: 29976784 DOI: 10.1136/bjophthalmol-2018-312125] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 06/14/2018] [Accepted: 06/21/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS To assess tumour control, vision and anatomical visual potential in eyes with perifoveal retinoblastoma treated by sequential photocoagulation from the antifoveal tumour edge inwards, avoiding treatment near the fovea. Patients were monitored for tumour control, foveal and perifoveal anatomy at each treatment session by optical coherence tomography (OCT) and treated for amblyopia when the other eye had better vision. METHODS Eyes with perifoveal retinoblastoma treated between 1 January 2011 and 31 May 2017 with laser therapy after chemotherapy for juxtafoveal (fovea clear of tumour but <3000 µm from tumour edge) or foveolar retinoblastoma (tumour underlying fovea) were retrospectively reviewed for tumour control without recurrence, anatomical success (foveal pit preservation and/or restoration with ≥500 µm perifoveal retina free of tumour and scar) and functional success (acceptable (>0.1 decimal) or good (>0.3 decimal) visual acuity (VA)). RESULTS Twenty-two eyes (14 juxtafoveal, 8 foveolar tumours) of 20 patients (19 bilateral, 1 familial and 11 females) were included. No juxtafoveal tumour had tumour recurrence, and 13/14 patients showed foveal pit preservation with ≥500 µm of perifoveal retina tumour free. Foveolar tumours had significant worse anatomical outcomes: failure to restore foveal pit or perifoveal retina (8/8, p=0.001) and tumour recurrences (5/8, p=0.001). Functional success with acceptable VA was achieved in 12/14 juxtafoveal and 5/8 foveal tumours eyes (p=0.01). Amblyopia therapy data were insufficient to evaluate impact on VA. CONCLUSIONS Anatomical visual potential and functional vision were better in juxtafoveal than foveolar retinoblastoma treated with foveal-sparing laser photocoagulation guided by OCT. The role of amblyopia therapy requires a prospective study.
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Affiliation(s)
- Sameh E Soliman
- Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, Ontario, Canada .,Department of Ophthalmology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Cynthia VandenHoven
- Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Leslie D Mackeen
- Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Brenda L Gallie
- Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Ophthalmology and Vision Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Departments of Molecular Genetics and Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Visual Sciences, Toronto Western Research Institute, Toronto, Ontario, Canada
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Kaufmann D, Burri C, Arnold P, Koch VM, Meier C, Považay B, Justiz J. Selective retina therapy enhanced with optical coherence tomography for dosimetry control and monitoring: a proof of concept study. BIOMEDICAL OPTICS EXPRESS 2018; 9:3320-3334. [PMID: 29984100 PMCID: PMC6033566 DOI: 10.1364/boe.9.003320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 06/09/2018] [Accepted: 06/11/2018] [Indexed: 06/01/2023]
Abstract
Selective treatment of the retinal pigment epithelium (RPE) by using short-pulse lasers leads to a less destructive treatment for certain retinal diseases in contrast to conventional photocoagulation. The introduction of selective retina therapy (SRT) to clinical routine is still precluded by the challenges to reliably monitor treatment success and to automatically adjust dose within the locally varying therapeutic window. Combining micrometer-scale depth resolving capabilities of optical coherence tomography (OCT) with SRT can yield real-time information on the laser-induced changes within the RPE after a laser pulse or even during treatment with a laser pulse train. In the present study, SRT and OCT were combined to treat ex-vivo porcine eyes demonstrating closed-loop dose-control. We found a reliable correlation of specific signal changes in time resolved OCT images and physiological lesions in the RPE. First experiments, including 23 porcine eyes, prove the feasibility of the novel treatment concept.
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Affiliation(s)
- Daniel Kaufmann
- Bern University of Applied Sciences, HuCE BME Lab, BFH-TI, CH-2501 Biel,
Switzerland
| | - Christian Burri
- Bern University of Applied Sciences, HuCE optoLab, BFH-TI, CH-2501 Biel,
Switzerland
| | - Patrik Arnold
- Bern University of Applied Sciences, HuCE optoLab, BFH-TI, CH-2501 Biel,
Switzerland
| | - Volker M. Koch
- Bern University of Applied Sciences, HuCE BME Lab, BFH-TI, CH-2501 Biel,
Switzerland
| | - Christoph Meier
- Bern University of Applied Sciences, HuCE optoLab, BFH-TI, CH-2501 Biel,
Switzerland
| | - Boris Považay
- Bern University of Applied Sciences, HuCE optoLab, BFH-TI, CH-2501 Biel,
Switzerland
| | - Jörn Justiz
- Bern University of Applied Sciences, HuCE BME Lab, BFH-TI, CH-2501 Biel,
Switzerland
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14
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Baek S, Lee KP, Cui L, Ryu Y, Hong JM, Kim J, Jung SH, Bae YM, Won KJ, Kim B. Low-power laser irradiation inhibits PDGF-BB-induced migration and proliferation via apoptotic cell death in vascular smooth muscle cells. Lasers Med Sci 2017; 32:2121-2127. [PMID: 28983687 DOI: 10.1007/s10103-017-2338-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 09/22/2017] [Indexed: 10/18/2022]
Abstract
Vascular restenosis after injury of blood vessel has been implicated in various responses including apoptosis, migration, and proliferation in vascular smooth muscle cells (VSMCs) stimulated by diverse growth factors underlying platelet-derived growth factor (PDGF). Previous studies evaluated the effects of low-power laser (LPL) irradiation over various wavelength ranges on VSMC events in normal and pathologic states. However, whether VSMC responses are affected by LPL irradiation remains unclear. The purpose of this study is to explore the effects of LPL (green diode laser 532-nm pulsed wave of 300 mW at a spot diameter of 1 mm) irradiation on the responses, apoptosis, migration, and proliferation of VSMCs. The effect of LPL irradiation was tested on VSMCs through cytotoxicity, proliferation, migration, and apoptotic assays. Aortic ring assay was used to assess the effect of LPL irradiation on aortic sprout outgrowth. Protein expression levels were determined by western blotting. LPL irradiation did not affect VSMC viability but slightly attenuated PDGF-BB-induced proliferation in VSMCs. In addition, LPL irradiation inhibited PDGF-BB-evoked migration of VSMCs. Aortic sprout outgrowth in response to PDGF-BB was diminished in cells treated with LPL. In contrast, LPL irradiation evoked apoptosis in VSMCs in the presence of PDGF-BB. Similarly, activation of caspase-3 and Bax, as well as p38 mitogen-activated protein kinase (MAPK), in VSMCs treated with PDGF-BB was enhanced by exposure to LPL. These findings indicate that LPL irradiation induces vascular apoptosis via p38 MAPK activation and simultaneously inhibits VSMC proliferation and migration in response to PDGF-BB.
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Affiliation(s)
- Suji Baek
- Department of Physiology, School of Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, South Korea
| | - Kang Pa Lee
- Department of Physiology, School of Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, South Korea
| | - Long Cui
- Department of Physiology, School of Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, South Korea
| | - Yunkyoung Ryu
- Department of Physiology, School of Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, South Korea
| | - Jung Min Hong
- Department of Physiology, School of Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, South Korea
| | - Junghwan Kim
- Department of Physical Therapy, College of Public Health & Welfare, Yongin University, Yongin, 17092, South Korea
| | - Seung Hyo Jung
- Department of Physiology, School of Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, South Korea
| | - Young Min Bae
- Department of Physiology, School of Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, South Korea
| | - Kyung Jong Won
- Department of Physiology, School of Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, South Korea.
| | - Bokyung Kim
- Department of Physiology, School of Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, South Korea.
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Palumbo MN, Cervantes O, Eugênio C, Hortense FTP, Ribeiro JC, Paolini AAP, Tedesco AC, Sercarz JA, Paiva MB. Intratumor cisplatin nephrotoxicity in combined laser-induced thermal therapy for cancer treatment. Lasers Surg Med 2017; 49:756-762. [DOI: 10.1002/lsm.22685] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Marcel N. Palumbo
- Department of Otolaryngology and Head and Neck Surgery; Federal University of São Paulo; São Paulo Brazil
| | - Onivaldo Cervantes
- Department of Otolaryngology and Head and Neck Surgery; Federal University of São Paulo; São Paulo Brazil
| | - Cecilia Eugênio
- Department of Otolaryngology and Head and Neck Surgery; Federal University of São Paulo; São Paulo Brazil
| | - Flávia T. P. Hortense
- Department of Otolaryngology and Head and Neck Surgery; Federal University of São Paulo; São Paulo Brazil
| | - João C. Ribeiro
- Department of Otolaryngology and Head and Neck Surgery; Federal University of São Paulo; São Paulo Brazil
| | | | - Antônio C. Tedesco
- Department of Chemistry, Laboratory of Photobiology and Photomedicine, Faculty of Philosophy; Science and Letters of the University of São Paulo; Ribeirão Preto, São Paulo Brazil
| | - Joel A. Sercarz
- Department of Head and Neck Surgery, David Geffen School of Medicine; University of California; Los Angeles California
| | - Marcos B. Paiva
- Department of Otolaryngology and Head and Neck Surgery; Federal University of São Paulo; São Paulo Brazil
- Department of Head and Neck Surgery, David Geffen School of Medicine; University of California; Los Angeles California
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Oellers P, Mruthyunjaya P. Low-dose brachytherapy strategies to treat uveal melanoma: is less more? Melanoma Manag 2016; 3:13-22. [PMID: 30190869 DOI: 10.2217/mmt.15.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 09/08/2015] [Indexed: 11/21/2022] Open
Abstract
The Collaborative Ocular Melanoma Study (COMS) has established equivalency of globe salvaging brachytherapy compared with enucleation in terms of survival for medium-sized choroidal melanoma. The radiation dose protocol followed by the COMS was 85 Gray to a prescription point of the tumor apex or 5 mm inner sclera; whichever was greater. While the COMS realized appropriate local and distant tumor control rates, ocular morbidity due to radiation complications remains a significant clinical challenge. Recent studies challenge the COMS radiation dose paradigm by demonstrating similar tumor control by utilizing lower radiation doses that are associated with reduced radiation toxicity. Improved operative techniques including intraoperative ultrasound can aid to obtain adequate radiation delivery to the tumor by ensuring optimal plaque position. Adjuvant transpupillary thermotherapy, intravitreal anti-VEGF and posterior sub-Tenon steroids may further enhance outcome by providing additional tumor control and/or facilitating visual recovery.
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Affiliation(s)
- Patrick Oellers
- Department of Ophthalmology, Duke University Medical School, Durham, NC, USA
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Nakamura M, Oyane A. Physicochemical fabrication of calcium phosphate-based thin layers and nanospheres using laser processing in solutions. J Mater Chem B 2016; 4:6289-6301. [DOI: 10.1039/c6tb01362g] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
We achieved simple and rapid fabrication of calcium phosphate (CaP)-based thin layers and nanospheres by laser processing in supersaturated solutions.
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Affiliation(s)
- Maki Nakamura
- Nanomaterials Research Institute
- National Institute of Advanced Industrial Science and Technology (AIST)
- Central 5
- Tsukuba
- Japan
| | - Ayako Oyane
- Nanomaterials Research Institute
- National Institute of Advanced Industrial Science and Technology (AIST)
- Central 5
- Tsukuba
- Japan
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