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Lefebvre A, Marhfor S, Baert G, Deleporte P, Grolez GP, Boileau M, Morales O, Vignoud S, Delhem N, Mortier L, Dewalle AS. Photodynamic Therapy Using a Rose-Bengal Photosensitizer for Hepatocellular Carcinoma Treatment: Proposition for a Novel Green LED-Based Device for In Vitro Investigation. Biomedicines 2024; 12:2120. [PMID: 39335633 PMCID: PMC11428738 DOI: 10.3390/biomedicines12092120] [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: 07/23/2024] [Revised: 09/04/2024] [Accepted: 09/10/2024] [Indexed: 09/30/2024] Open
Abstract
Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. Despite new treatments, the HCC rate remains important, making it necessary to develop novel therapeutic strategies. Photodynamic therapy (PDT) using a Rose-Bengal (RB) photosensitizer (RB-PDT) could be a promising approach for liver tumor treatment. However, the lack of standardization in preclinical research and the diversity of illumination parameters used make comparison difficult across studies. This work presents and characterizes a novel illumination device based on one green light-emitting diode (CELL-LED-550/3) dedicated to an in vitro RB-PDT. The device was demonstrated to deliver a low average irradiance of 0.62 mW/cm2 over the 96 wells of a multi-well plate. Thermal characterization showed that illumination does not cause cell heating and can be performed inside an incubator, allowing a more rigorous assessment of cell viability after PDT. An in vitro cytotoxic study of the RB-PDT on an HCC cell line (HepG2) demonstrated that RB-PDT induces a significant decrease in cell viability: almost all the cells died after a light dose irradiation of 0.3 J/cm2 using 75 µM of RB (<10% of viability). In conclusion, the RB-PDT could be a therapeutic option to treat unresectable liver lesions and subclinical disease remaining in the post-resection tumor surgical margin.
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Affiliation(s)
- Anthony Lefebvre
- Inserm, CHU Lille, U1189-ONCO-THAI-Assisted Laser Therapy and Immunotherapy for Oncology, University of Lille, 59000 Lille, France
| | - Smail Marhfor
- Inserm, CHU Lille, U1189-ONCO-THAI-Assisted Laser Therapy and Immunotherapy for Oncology, University of Lille, 59000 Lille, France
- CEA, LETI, University of Grenoble Alpes, 38000 Grenoble, France
| | - Gregory Baert
- Inserm, CHU Lille, U1189-ONCO-THAI-Assisted Laser Therapy and Immunotherapy for Oncology, University of Lille, 59000 Lille, France
| | - Pascal Deleporte
- Inserm, CHU Lille, U1189-ONCO-THAI-Assisted Laser Therapy and Immunotherapy for Oncology, University of Lille, 59000 Lille, France
| | - Guillaume Paul Grolez
- Inserm, CHU Lille, U1189-ONCO-THAI-Assisted Laser Therapy and Immunotherapy for Oncology, University of Lille, 59000 Lille, France
| | - Marie Boileau
- Inserm, CHU Lille, U1189-ONCO-THAI-Assisted Laser Therapy and Immunotherapy for Oncology, University of Lille, 59000 Lille, France
- Department of Dermatology, Claude Huriez Hospital, CHU Lille, 59000 Lille, France
| | - Olivier Morales
- Inserm, CHU Lille, U1189-ONCO-THAI-Assisted Laser Therapy and Immunotherapy for Oncology, University of Lille, 59000 Lille, France
- CNRS, Inserm, CHU Lille, UMR9020-U1277-CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, University of Lille, 59000 Lille, France
| | | | - Nadira Delhem
- Inserm, CHU Lille, U1189-ONCO-THAI-Assisted Laser Therapy and Immunotherapy for Oncology, University of Lille, 59000 Lille, France
| | - Laurent Mortier
- Inserm, CHU Lille, U1189-ONCO-THAI-Assisted Laser Therapy and Immunotherapy for Oncology, University of Lille, 59000 Lille, France
- Department of Dermatology, Claude Huriez Hospital, CHU Lille, 59000 Lille, France
| | - Anne-Sophie Dewalle
- Inserm, CHU Lille, U1189-ONCO-THAI-Assisted Laser Therapy and Immunotherapy for Oncology, University of Lille, 59000 Lille, France
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Udrea AM, Smarandache A, Dinache A, Mares C, Nistorescu S, Avram S, Staicu A. Photosensitizers-Loaded Nanocarriers for Enhancement of Photodynamic Therapy in Melanoma Treatment. Pharmaceutics 2023; 15:2124. [PMID: 37631339 PMCID: PMC10460031 DOI: 10.3390/pharmaceutics15082124] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Malignant melanoma poses a significant global health burden. It is the most aggressive and lethal form of skin cancer, attributed to various risk factors such as UV radiation exposure, genetic modifications, chemical carcinogens, immunosuppression, and fair complexion. Photodynamic therapy is a promising minimally invasive treatment that uses light to activate a photosensitizer, resulting in the formation of reactive oxygen species, which ultimately promote cell death. When selecting photosensitizers for melanoma photodynamic therapy, the presence of melanin should be considered. Melanin absorbs visible radiation similar to most photosensitizers and has antioxidant properties, which undermines the reactive species generated in photodynamic therapy processes. These characteristics have led to further research for new photosensitizing platforms to ensure better treatment results. The development of photosensitizers has advanced with the use of nanotechnology, which plays a crucial role in enhancing solubility, optical absorption, and tumour targeting. This paper reviews the current approaches (that use the synergistic effect of different photosensitizers, nanocarriers, chemotherapeutic agents) in the photodynamic therapy of melanoma.
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Affiliation(s)
- Ana Maria Udrea
- Lasers Department, National Institute for Lasers, Plasma and Radiation Physics, 409 Atomistilor Str., 077125 Magurele, Romania; (A.M.U.); (A.D.); (S.N.)
- Department of Anatomy, Animal Physiology and Biophysics, Faculty of Biology, University of Bucharest, 91-95 Splaiul Independentei, 050095 Bucharest, Romania; (C.M.); (S.A.)
| | - Adriana Smarandache
- Lasers Department, National Institute for Lasers, Plasma and Radiation Physics, 409 Atomistilor Str., 077125 Magurele, Romania; (A.M.U.); (A.D.); (S.N.)
| | - Andra Dinache
- Lasers Department, National Institute for Lasers, Plasma and Radiation Physics, 409 Atomistilor Str., 077125 Magurele, Romania; (A.M.U.); (A.D.); (S.N.)
| | - Catalina Mares
- Department of Anatomy, Animal Physiology and Biophysics, Faculty of Biology, University of Bucharest, 91-95 Splaiul Independentei, 050095 Bucharest, Romania; (C.M.); (S.A.)
| | - Simona Nistorescu
- Lasers Department, National Institute for Lasers, Plasma and Radiation Physics, 409 Atomistilor Str., 077125 Magurele, Romania; (A.M.U.); (A.D.); (S.N.)
| | - Speranta Avram
- Department of Anatomy, Animal Physiology and Biophysics, Faculty of Biology, University of Bucharest, 91-95 Splaiul Independentei, 050095 Bucharest, Romania; (C.M.); (S.A.)
| | - Angela Staicu
- Lasers Department, National Institute for Lasers, Plasma and Radiation Physics, 409 Atomistilor Str., 077125 Magurele, Romania; (A.M.U.); (A.D.); (S.N.)
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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.
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Baydoun M, Moralès O, Frochot C, Ludovic C, Leroux B, Thecua E, Ziane L, Grabarz A, Kumar A, de Schutter C, Collinet P, Azais H, Mordon S, Delhem N. Photodynamic Therapy Using a New Folate Receptor-Targeted Photosensitizer on Peritoneal Ovarian Cancer Cells Induces the Release of Extracellular Vesicles with Immunoactivating Properties. J Clin Med 2020; 9:jcm9041185. [PMID: 32326210 PMCID: PMC7230754 DOI: 10.3390/jcm9041185] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/11/2020] [Accepted: 04/12/2020] [Indexed: 12/12/2022] Open
Abstract
Often discovered at an advanced stage, ovarian cancer progresses to peritoneal carcinoma, which corresponds to the invasion of the serosa by multiple tumor implants. The current treatment is based on the combination of chemotherapy and tumor cytoreduction surgery. Despite the progress and standardization of surgical techniques combined with effective chemotherapy, post-treatment recurrences affect more than 60% of women in remission. Photodynamic therapy (PDT) has been particularly indicated for the treatment of superficial lesions on large surfaces and appears to be a relevant candidate for the treatment of microscopic intraperitoneal lesions and non-visible lesions. However, the impact of this therapy on immune cells remains unclear. Hence, the objective of this study is to validate the efficacy of a new photosensitizer [pyropheophorbide a-polyethylene glycol-folic acid (PS)] on human ovarian cancer cells and to assess the impact of the secretome of PDT-treated cells on human peripheral blood mononuclear cells (PBMC). We show that PS, upon illumination, can induce cell death of different ovarian tumor cells. Furthermore, PDT using this new PS seems to favor activation of the immune response by inducing the secretion of effective cytokines and inhibiting the pro-inflammatory and immunosuppressive ones, as well as releasing extracellular vesicles (EVs) prone to activating immune cells. Finally, we show that PDT can activate CD4+ and CD8+ T cells, resulting in a potential immunostimulating process. The results of this pilot study therefore indicate that PS-PDT treatment may not only be effective in rapidly and directly destroying target tumor cells but also promote the activation of an effective immune response; notably, by EVs. These data thus open up good prospects for the treatment of micrometastases of intraperitoneal ovarian carcinosis which are currently inoperable.
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Affiliation(s)
- Martha Baydoun
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
| | - Olivier Moralès
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
- CNRS UMS 3702, Institut de Biologie de Lille, 59 021 Lille, France
| | - Céline Frochot
- LGRGP, UMR-CNRS 7274, University of Lorraine, 54 001 Nancy, France; (C.F.); (C.L.)
| | - Colombeau Ludovic
- LGRGP, UMR-CNRS 7274, University of Lorraine, 54 001 Nancy, France; (C.F.); (C.L.)
| | - Bertrand Leroux
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
| | - Elise Thecua
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
| | - Laurine Ziane
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
| | - Anne Grabarz
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
- Unité de Gynécologie-Obstétrique, Hôpital Jeanne de Flandre, 59 000 CHU Lille, France
| | - Abhishek Kumar
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
| | - Clémentine de Schutter
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
| | - Pierre Collinet
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
- Unité de Gynécologie-Obstétrique, Hôpital Jeanne de Flandre, 59 000 CHU Lille, France
| | - Henri Azais
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
- Service de Chirurgie et Cancérologie Gynécologique et Mammaire, Hôpital de la Pitié-Salpêtrière, AP-HP, 75 013 Paris, France
| | - Serge Mordon
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
- Correspondence: (S.M.); (N.D.); Tel./Fax: +33-32044-6708 (S.M.); Tel.: +33-3208-71253/1251 (N.D.); Fax: +33-32087-1019 (N.D.)
| | - Nadira Delhem
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
- Correspondence: (S.M.); (N.D.); Tel./Fax: +33-32044-6708 (S.M.); Tel.: +33-3208-71253/1251 (N.D.); Fax: +33-32087-1019 (N.D.)
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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.
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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
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Use of 5-Aminolevulinic Acid and Daylight Photodynamic Therapy for the Treatment of Actinic Keratoses. Dermatol Surg 2019; 45:529-535. [DOI: 10.1097/dss.0000000000001771] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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LaRochelle EPM, Marra K, LeBlanc RE, Chapman MS, Maytin EV, Pogue BW. Modeling PpIX effective light fluence at depths into the skin for PDT dose comparison. Photodiagnosis Photodyn Ther 2019; 25:425-435. [PMID: 30685548 DOI: 10.1016/j.pdpdt.2019.01.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 01/04/2019] [Accepted: 01/18/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Daylight-activated PDT has seen increased support in recent years as a treatment method for actinic keratosis and other non-melanoma skin cancers. The inherent variability observed in broad-spectrum light used in this methodology makes it difficult to plan and monitor light dose, or compare to lamp light doses. METHODS The present study expands on the commonly used PpIX-weighted effective surface irradiance metric by introducing a Monte Carlo method for estimating effective fluence rates into depths of the skin. The fluence rates are compared between multiple broadband and narrowband sources that have been reported in previous studies, and an effective total fluence for various treatment times is reported. A dynamic estimate of PpIX concentration produced during pro-drug incubation and treatment is used with the fluence estimates to calculate a photodynamic dose. RESULTS Even when there is up to a 5x reduction between the effective surface irradiance of the broadband light sources, the effective fluence below 250 μm depth is predicted to be relatively equivalent. An effective threshold fluence value (0. 70Jeff/cm2) is introduced based on a meta-analysis of previously published ALA-PpIX induced cell death. This was combined with a threshold PpIX concentration (50 nM) to define a threshold photodynamic dose of 0.035 u M Jeff/cm2. CONCLUSIONS The threshold was used to generate lookup tables to prescribe minimal treatment times to achieve depth-dependent cytotoxic effect based on incubation times and irradiance values for each light source.
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Affiliation(s)
| | - Kayla Marra
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, USA
| | - Robert E LeBlanc
- Department Pathology & Laboratory Medicine, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
| | - M Shane Chapman
- Department of Surgery, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
| | - Edward V Maytin
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Brian W Pogue
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, USA; Department of Surgery, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
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Vignion-Dewalle AS, Baert G, Thecua E, Lecomte F, Vicentini C, Abi-Rached H, Mortier L, Mordon S. Comparison of 10 efficient protocols for photodynamic therapy of actinic keratosis: How relevant are effective light dose and local damage in predicting the complete response rate at 3 months? Lasers Surg Med 2018; 50:576-589. [PMID: 29667728 DOI: 10.1002/lsm.22827] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND Topical photodynamic therapy is an established treatment modality for various dermatological conditions, including actinic keratosis. In Europe, the approved protocols for photodynamic therapy of actinic keratosis involve irradiation with either an Aktilite CL 128 lamp or daylight, whereas irradiation with the Blu-U illuminator is approved in the United States. Many other protocols using irradiation by a variety of light sources are also clinically efficient. OBJECTIVES This paper aims to compare 10 different protocols with clinically proven efficacy for photodynamic therapy of actinic keratosis and the available spectral irradiance of the light source. Effective irradiance, effective light dose, and local damage are compared. We also investigate whether there is an association between the complete response rate at 3 months and the effective light dose or local damage. METHODS The effective irradiance, also referred to as protoporphyrin IX-weighted irradiance, is obtained by integrating the spectral irradiance weighted by the normalized absorption spectrum of protoporphyrin IX over the wavelength. Integrating the effective irradiance over the irradiation time yields the effective light dose, which is also known as the protoporphyrin IX-weighted light dose. Local damage, defined as the total cumulative singlet oxygen molecules produced during treatment, is estimated using mathematical modeling of the photodynamic therapy process. This modeling is based on an iterative procedure taking into account the spatial and temporal variations in the protoporphyrin IX absorption spectrum during treatment. RESULTS The protocol for daylight photodynamic therapy on a clear sunny day, the protocol for daylight photodynamic therapy on an overcast day, the photodynamic therapy protocol for a white LED lamp for operating rooms and the photodynamic therapy protocol for the Blu-U illuminator perform better than the six other protocols-all involving red light illumination-in terms of both effective light dose and local damage. However, no association between the complete response rate at 3 months and the effective light dose or local damage was found. CONCLUSIONS Protocols that achieve high complete response rates at 3 months and low pain scores should be preferred regardless of the effective light dose and local damage. Lasers Surg. Med. 50:576-589, 2018. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Anne-Sophie Vignion-Dewalle
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France
| | - Gregory Baert
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France
| | - Elise Thecua
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France
| | - Fabienne Lecomte
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France
| | - Claire Vicentini
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France.,Department of Dermatology, CHU Lille, Lille, F-5900, France
| | - Henry Abi-Rached
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France.,Department of Dermatology, CHU Lille, Lille, F-5900, France
| | - Laurent Mortier
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France.,Department of Dermatology, CHU Lille, Lille, F-5900, France
| | - Serge Mordon
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France
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9
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Bagatin E. Treating actinic keratosis: assessment of effectiveness, discomfort, costs and follow-up. Br J Dermatol 2018; 178:322-323. [DOI: 10.1111/bjd.16228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- E. Bagatin
- Department of Dermatology; Escola Paulista de Medicina - Universidade Federal de Sao Paulo; 508, Borges Lagoa St - 04038-000 Sao Paulo SP Brazil
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