Post-Operational Photodynamic Therapy of the Tumor Bed: Comparative Analysis for Cold Knife and Laser Scalpel Resection

In this paper, we report on a study regarding the efficiency of the post-operational phototherapy of the tumor bed after resection with both a cold knife and a laser scalpel in laboratory mice with CT-26 tumors. Post-operational processing included photodynamic therapy (PDT) with a topically applied chlorin-based photosensitizer (PS), performed at wavelengths of 405 or 660 nm, with a total dose of 150 J/cm2. The selected design of the tumor model yielded zero recurrence in the laser scalpel group and 92% recurrence in the cold knife group without post-processing, confirming the efficiency of the laser scalpel in oncology against the cold knife. The application of PDT after the cold knife resection decreased the recurrence rate to 70% and 42% for the 405 nm and 660 nm procedures, respectively. On the other hand, the application of PDT after the laser scalpel resection induced recurrence rates of 18% and 30%, respectively, for the considered PDT performance wavelengths. The control of the penetration of PS into the tumor bed by fluorescence confocal microscopy indicated the deeper penetration of PS in the case of the cold knife, which presumably provided deeper PDT action, while the low-dose light exposure of deeper tissues without PS, presumably, stimulated tumor recurrence, which was also confirmed by the differences in the recurrence rate in the 405 and 660 nm groups. Irradiation-only light exposures, in all cases, demonstrated higher recurrence rates compared to the corresponding PDT cases. Thus, the PDT processing of the tumor bed after resection could only be recommended for the cold knife treatment and not for the laser scalpel resection, where it could induce tumor recurrence.

A monolithic microsphere-fiber probe for spatially resolved Raman spectroscopy: Application to head and neck squamous cell carcinomas

The ability to identify precise cancer margins in vivo during a surgical excision is critical to the well-being of the patient. Decreased operative time has been linked to shorter patient recovery time, and there are risks associated with removing either too much or too little tissue from the surgical site. The more rapidly and accurately a surgeon can identify and excise diseased tissue, the better the prognosis for the patient. To this end, we investigate both malignant and healthy oral cavity tissue using the Raman spectroscopy, with a monolithic microsphere-fiber probe. Our results indicate that this probe has decreased the size of the analyzed area by more than an order of magnitude, as compared to a conventional fiber reflection probe. Scanning the probe across the tissues reveals variations in the Raman spectra that enable us to differentiate between malignant and healthy tissues. Consequently, we anticipate that the high spatial resolution afforded by the probe will permit us to identify tumor margins in detail, thereby optimizing tissue removal and improving patient outcomes.