Photodiagnosis and Photodynamic Therapy RSS feed: Current Issue. New for 2009: Official Journal of the European Platform for Photodynamic Medicine Also affiliated with the British Medical Laser Association and the Polish Society for Photodynamic Medicine NOW INDEXED in SciSearch/Science Citation Index Expanded, Current Contents/Clinical Medicine. NOW INCLUDED in MEDLINE/PubMed. Aims and Scope Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process. Electronic usage: An increasing number of readers access the journal online via ScienceDirect, one of the world's most advanced web delivery systems for scientific, technical and medical information. Average monthly article downloads for this journal: 1,559* * Figure is an average based on full text articles downloaded monthly via ScienceDirect between August 2008 and March 2009 http://www.pdpdt-journal.com/?rss=yesElsevier Inc.en © 2009 Published by Elsevier Inc. All rights reserved. Photodiagnosis and Photodynamic Therapy1572-100063-4September 2009 © 2009 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.pdpdt-journal.com/article/PIIS1572100009001458/abstract?rss=yesEditorial Board10.1016/S1572-1000(09)00145-8Photodiagnosis and Photodynamic Therapy 6, 3 (2009)2009-09-01Photodiagnosis and Photodynamic Therapy2009-09-0163-4S1572-1000(09)X0005-0iihttp://www.pdpdt-journal.com/article/PIIS1572100009001318/abstract?rss=yesIt has been said that the hallmark of a good study is that it should not only address a fundamentally important question, but that it should leave several additional questions unanswered, providing fertile ground for future research. The report by Moghissi et al. does indeed address an important question related to the management of early stage esophageal malignancy. Although the background to this challenging clinical entity is well discussed in the “literature review” component of this paper, it is worth reiterating a number of key issues.Photofrin PDT for early stage esophageal cancer: A new standard of care?Alan G. Casson10.1016/j.pdpdt.2009.09.002Photodiagnosis and Photodynamic Therapy 6, 3 (2009)2009-10-05Photodiagnosis and Photodynamic Therapy2009-10-0563-4S1572-1000(09)X0005-0Editorials155156http://www.pdpdt-journal.com/article/PIIS1572100009001240/abstract?rss=yesThe management of early cancer of the oesophagus is now an area of intense discussion. A vital contribution appears in this issue with the important concluding statement that ‘endoscopic PDT should be considered the treatment of choice in patients with early oesophageal cancer who are ineligible for surgical resection.’ This conclusion must provoke a full discussion and detailed examination. The authors correctly call for a more information in a cohort study: but what of resolving the issue with a randomised trial. What of PDT for the treatment of early cancer in patients who are eligible for surgery. Currently there are proposals among the Barrett's Esophagus Ablation Trial (BEAT) group to look at trial of surgery versus endotherapy (endoscopic mucosal resection alone or combined with ablation therapy) for early mucosal cancer in Barrett's oesophagus. The issues are very difficult and the trial planning is well advanced. Is it a treatment option that can be discussed with all patients, since radical surgical resection is such morbid and mortal procedurem, but is well established curative therapy? Moghissi and colleagues have added impetus to this effort with this very important paper. They clearly have good data from a retrospective series of patients with early oesophageal cancer treated using photodynamic therapy. Forty patients (35 with an adenocarcinoma) had a median survival of 41 months after treatment. The exact stage of the disease is of course difficult to certain of without a histopathological examination of the resected specimen. Nevertheless, the overall conclusion is that these patients do achieve a prolonged survival benefit following endoscopic photodynamic therapy.Photodynamic therapy for eradication of early oesophageal cancer. ‘Will the complete proof weary the truth’Hugh Barr10.1016/j.pdpdt.2009.07.027Photodiagnosis and Photodynamic Therapy 6, 3 (2009)2009-09-07Photodiagnosis and Photodynamic Therapy2009-09-0763-4S1572-1000(09)X0005-0Editorials157158http://www.pdpdt-journal.com/article/PIIS1572100009001008/abstract?rss=yesSummary: Background: Yorkshire Laser Centre experience of PDT in early oesophageal cancer (EOCa) to determine long survival at 3 and 5 years (absolute) and factors which might influence outcome.Material/Method: The records of patients who had PDT (1997–2009) for oesophageal cancer were reviewed and those with EOCa were studied and analysed. All patients had standard work up and staging. PDT was carried out using Photofrin 2mg/kwbw, iv followed 24–72h later by endoscopic illumination with 630nm laser light. Results were assessed based on pathological response to treatment and survival at 3 and 5 years post-PDT.Results: There were 40 patients with EOCa amongst 144 who had PDT for oesophageal cancer. 30 male and 10 female (mean age 77, range 48–84). 35 had adenocarcinoma and 5 squamous cell carcinoma. 20 of the former had Barrett's mucosa. There was no operative or 30-day mortality and no serious complications. Adverse effects were noted in 10 patients including 2 with skin photosensitivity and 3 with mild stricture requiring one dilatation. The median follow up was 76.1 (range 36–150 months). In this period 24 patients have died between 2 and 150 months (median 41 months). 16 patients are alive in between 36 and 110 months. 3 and ≥5 years or more survival (absolute) were 72.5% and 53.8%, respectively.Conclusion: Endoscopic PDT should be considered as the treatment of choice in patients with EOCa who are ineligible for surgical resection. We suggest that a carefully designed study of a cohort of patients with EOCa comparing surgical resection with endoscopic PDT is warranted.Photofrin PDT for early stage oesophageal cancer: Long term results in 40 patients and literature reviewK. Moghissi, Kate Dixon, Mark Stringer, J.A.C. Thorpe10.1016/j.pdpdt.2009.07.026Photodiagnosis and Photodynamic Therapy 6, 3 (2009)2009-08-25Photodiagnosis and Photodynamic Therapy2009-08-2563-4S1572-1000(09)X0005-0Articles159166http://www.pdpdt-journal.com/article/PIIS1572100009001409/abstract?rss=yesSummary: In the face of increasing multi-drug resistant bacteria, both in healthcare and the community, new drugs or novel methods of decontamination are required. The use of light-activated drugs – photoantimicrobials – has been promoted at various points during the past decade or more but has not yet gained meaningful clinical acceptance. Photoantimicrobials offer advantages over conventional drugs in attacking bacteria at various sites, rather than just one, and in the intermediacy of reactive oxygen species, against which there is little possibility of resistance.Photoantimicrobials—So what's stopping us?Mark Wainwright10.1016/j.pdpdt.2009.10.007Photodiagnosis and Photodynamic Therapy 6, 3 (2009)2009-11-16Photodiagnosis and Photodynamic Therapy2009-11-1663-4S1572-1000(09)X0005-0Articles167169http://www.pdpdt-journal.com/article/PIIS1572100009001410/abstract?rss=yesSummary: Photodynamic therapy (PDT) was discovered over 100 years ago by observing the killing of microorganisms when harmless dyes and visible light were combined in vitro. Since then it has primarily been developed as a treatment for cancer, ophthalmologic disorders and in dermatology. However, in recent years interest in the antimicrobial effects of PDT has revived and it has been proposed as a therapy for a large variety of localized infections. This revival of interest has largely been driven by the inexorable increase in drug resistance among many classes of pathogen. Advantages of PDT include equal killing effectiveness regardless of antibiotic resistance, and a lack of induction of PDT resistance. Disadvantages include the cessation of the antimicrobial effect when the light is turned off, and less than perfect selectivity for microbial cells over host tissue. This review will cover the use of PDT to kill or inactivate pathogens in ex vivo tissues and in biological materials such as blood. PDT has been successfully used to kill pathogens and even to save life in several animal models of localized infections such as surface wounds, burns, oral sites, abscesses and the middle ear. A large number of clinical studies of PDT for viral papillomatosis lesions and for acne refer to its antimicrobial effect, but it is unclear how important this microbial killing is to the overall therapeutic outcome. PDT for periodontitis is a rapidly growing clinical application and other dental applications are under investigation. PDT is being clinically studied for other dermatological infections such as leishmaniasis and mycobacteria. Antimicrobial PDT will become more important in the future as antibiotic resistance is only expected to continue to increase.Photodynamic therapy for localized infections—State of the artTianhong Dai, Ying-Ying Huang, Michael R. Hamblin10.1016/j.pdpdt.2009.10.008Photodiagnosis and Photodynamic Therapy 6, 3 (2009)2009-11-19Photodiagnosis and Photodynamic Therapy2009-11-1963-4S1572-1000(09)X0005-0Reviews170188http://www.pdpdt-journal.com/article/PIIS1572100009001288/abstract?rss=yesSummary: Port wine stain (PWS) birthmarks are congenital vascular malformations characterized by ectatic capillaries in the papillary layer of the dermis. They usually appear at birth and tend to become darker and thicker with age. Cosmetic and pathological changes can cause great depression in all ages. Laser-mediated selective photothermolysis is the treatment of choice but vascular-targeted photodynamic therapy (PDT) might be an alternative approach in the treatment of PWS. PDT has shown therapeutic benefit in pink and resistant lesions. In theory, vascular-targeted PDT may be more efficient in terms of better lightening and less treatment sessions than pulsed dye laser (PDL) irradiation. Chinese clinicians have gained profound knowledge and accumulated a large body of clinical experience in PWS PDT in the past years. The pursuing of regulatory approval on PWS PDT is currently underway. In this article we will report our experience in PWS PDT, discuss current PDT protocols and introduce the novel combination therapy, such as PDT+PDL and PDT+topical angiogenic inhibitor.Photodynamic therapy in treatment of port wine stain birthmarks—Recent progressKai-Hua Yuan, Qin Li, Wen-Lin Yu, Zheng Huang10.1016/j.pdpdt.2009.08.001Photodiagnosis and Photodynamic Therapy 6, 3 (2009)2009-09-11Photodiagnosis and Photodynamic Therapy2009-09-1163-4S1572-1000(09)X0005-0Reviews189194http://www.pdpdt-journal.com/article/PIIS1572100009001355/abstract?rss=yesSummary: Background: Pulsed dye laser (PDL) is a commonly utilized treatment for port wine stain birthmarks (PWS) in the United States; however, results are variable and few patients achieve complete removal. Photodynamic therapy (PDT) is commonly used in China, but treatment associated photosensitivity lasts several weeks and scarring may occur. We propose an alternative treatment option, combined PDT+PDL and performed a proof-of-concept preliminary clinical trial.Methods: Subjects with non-facial PWS were studied. Each subject had four test sites: control, PDL alone, PDT alone (benzoporphyrin derivative monoacid ring A photosensitizer with 576nm light), and PDT+PDL. Radiant exposure time for PDT was increased in increments of 15J/cm2. Authors evaluated photographs and chromametric measurements before and 12 weeks post-treatment.Results: No serious adverse events were reported; epidermal changes were mild and self-limited. No clinical blanching was noted in control or PDT-alone sites. At PDT radiant exposures of 15 and 30J/cm2, equivalent purpura and blanching was observed at PDL and PDT+PDL sites. At PDT radiant exposures over 30J/cm2, greater purpura was noted at PDT+PDL sites as compared to PDL alone. Starting at 75J/cm2, improved blanching was noted at PDT+PDL sites.Conclusions: Preliminary results indicate that PDT+PDL is safe and may offer improved PWS treatment efficacy. Additional studies are warranted.Combined benzoporphyrin derivative monoacid ring photodynamic therapy and pulsed dye laser for port wine stain birthmarksJoshua A. Tournas, Jennifer Lai, Anne Truitt, Y.C. Huang, Kathryn E. Osann, Bernard Choi, Kristen M. Kelly10.1016/j.pdpdt.2009.10.002Photodiagnosis and Photodynamic Therapy 6, 3 (2009)2009-11-13Photodiagnosis and Photodynamic Therapy2009-11-1363-4S1572-1000(09)X0005-0Articles195199http://www.pdpdt-journal.com/article/PIIS157210000900129X/abstract?rss=yesSummary: Treatment of 5,10,15,20-tetra(pentafluorophenyl) porphyrins with polyethylene glycol (PEG) halides and sodium sulfide is a mild and efficient route to water-soluble PEG substituted porphyrins. The method has been used to access a series of free-base and metallated PEG porphyrins, which have been investigated for photodynamic activity against Human Caucasian colon adenocarcinoma (Caco2) cells. Toxicity, in the presence and absence of light, is shown to be affected by the length of the PEG chain, nature of coordinated metal and axial ligand.Synthesis and phototoxicity of polyethylene glycol (PEG) substituted metal-free and metallo-porphyrins: Effect of PEG chain length, coordinated metal, and axial ligandRyan E. Mewis, Huguette Savoie, Stephen J. Archibald, Ross W. Boyle10.1016/j.pdpdt.2009.08.002Photodiagnosis and Photodynamic Therapy 6, 3 (2009)2009-10-12Photodiagnosis and Photodynamic Therapy2009-10-1263-4S1572-1000(09)X0005-0Articles200206http://www.pdpdt-journal.com/article/PIIS1572100009001306/abstract?rss=yesSummary: Photodynamic therapy (PDT) is based on the association of a light source and light sensitive agents in order to cause the selective death of tumor cells. To evaluate topical 5-aminolaevulinic acid (5-ALA) and diode laser photodynamic single session therapy single session for non-melanoma skin cancer (NMSC), a long-term follow-up was performed. Nineteen Bowen's disease (BD) and 15 basal cell carcinoma (BCC) lesions were submitted to 6-h topical and occlusive 20% 5-ALA plus DMSO and EDTA, and later were exposed to 630nm diode laser, 100 or 300Jcm−2 dose. At 3 months tumor-free rate was 91.2% (31/34) whereas at 60 months, 57.7% (15/26), slightly higher in BCC (63.6%; 7/11). The relation between the reduction of the clinical response and the increase of tumor dimension observed at 18 months was lost at 60 months. The sBCC recurrence was earlier compared to the nBCC one. ALA-PDT offered important advantages: it is minimally invasive, an option for patients under risk of surgical complications; clinical feasibility; treatment of multiple lesions in only one session or lesions in poor healing sites and superior esthetical results. However, the recurrence rate increase after ALA-PDT diode laser single session can be observed at long-term follow-up, and the repetitive sessions, an additional advantage of the method, is strongly recommended. The clinical response and recurrence time seem to be related to the laser light dose and NMSC types/sub-types, thickness and dimension, which must be considered for the choice of the ALA-PDT.Long-term follow-up of topical 5-aminolaevulinic acid photodynamic therapy diode laser single session for non-melanoma skin cancerC.S. Souza, L.B.A. Felicio, J. Ferreira, C. Kurachi, M.V.B. Bentley, A.C. Tedesco, V.S. Bagnato10.1016/j.pdpdt.2009.09.001Photodiagnosis and Photodynamic Therapy 6, 3 (2009)2009-10-16Photodiagnosis and Photodynamic Therapy2009-10-1663-4S1572-1000(09)X0005-0Articles207213http://www.pdpdt-journal.com/article/PIIS1572100009001422/abstract?rss=yesSummary: Background: Photodynamic therapy is an established cancer treatment in which a photosensitizing agent is activated by exposure to light thus generating cytotoxic reactive oxygen species that cause cellular damage.Methods: A new photosensitizer synthesized at Curie Institute was used to treat retinoblastoma xenografts in mice, a glycoconjugated meso substituted porphyrin derivative, that showed some retinoblastoma cell affinity. The longitudinal follow-up of the tumors was carried out by 23Na MRI (without adding exogenous contrast agents) to map the extracellular compartment and to characterize cell packing. Two regimens were followed to target either blood vessels alone or blood vessels and cancer cells simultaneously.Results and conclusions: Only the protocol targeting both cancer cells and blood vessels effectively induces cellular death, confirmed by histology at the end of the experiment. Sodium MRI evidences a huge change in the cellular density of tumors only 24h after a double targeting (vascular and cellular) PDT treatment. We suggest that this change was possibly due to a bystander effect that can be promoted by the intercellular signaling favored by the high cellular density of retinoblastoma. These results indicate that non-invasive 23Na imaging (which detects the tumor response to treatment from very early stages) in association with non-mutagenic therapies represents an effective option for tailored and individualized clinical treatments.23Na MRI longitudinal follow-up of PDT in a xenograft model of human retinoblastomaMihaela Lupu, Carole D. Thomas, Philippe Maillard, Bernard Loock, Benoit Chauvin, Isabelle Aerts, Alain Croisy, Elodie Belloir, Andreas Volk, Joel Mispelter10.1016/j.pdpdt.2009.10.009Photodiagnosis and Photodynamic Therapy 6, 3 (2009)2009-11-20Photodiagnosis and Photodynamic Therapy2009-11-2063-4S1572-1000(09)X0005-0Articles214220http://www.pdpdt-journal.com/article/PIIS1572100009001379/abstract?rss=yesSummary: Objectives: There is need for a cheap, sensitive, and specific method to identify and localize early stage lung cancer. In order to improve the sensitivity of fluorescent agents that exhibit selective tumor uptake that are used as population screening tools for the detection of early lung cancer, a number of porphyrins including protoporphyrin-IX (PpIX) were tested. We stained lung cancer cells using three different sample preparation schemes for fluorescence microscopy.Methods: Lung tissues and sputum samples of nineteen patients were studied. Cells were collected on glass slides by touching tumor surfaces of surgically sectioned lung cancer tissue and normal regions of the lung during surgery. Filtered sputum cells were also collected. Cell-attached slides were stained with porphyrin using three different methods, including fixing (SM-1) prior to staining, and diluting porphyrin stock solutions in either RPMI-1640 medium (SM-2) or 100mM MES buffer (SM-3).Results: Slides from normal lung tissue lacked fluorescent epithelial cells. Tumor slides containing typical lung cancer cells exhibited red fluorescence upon excitation through the soret band (400–450nm) of porphyrin compounds. Tumor-selective staining was only observed on unfixed tumor slides that were incubated with PpIX in a RPMI-1640 culture medium (SM-3) used as a working solution for staining and washing.Conclusions: Protoporphyrin-IX is a potentially useful tumor-staining molecular agent for fluorescent location of cancer cell in sputum samples from lung cancer patients.A preliminary study of protoporphyrin-IX as a potential candidate for identification of lung cancer cells using fluorescence microscopyDae-Sung Hyun, Hong-Tae Kim, Sang-Hoon Jheon, Seung-Il Park, Jong-Ki Kim10.1016/j.pdpdt.2009.10.004Photodiagnosis and Photodynamic Therapy 6, 3 (2009)2009-11-19Photodiagnosis and Photodynamic Therapy2009-11-1963-4S1572-1000(09)X0005-0Articles221226http://www.pdpdt-journal.com/article/PIIS157210000900132X/abstract?rss=yesSummary: Cerebral metastases occur in 15–40% of cancers and their incidence is increasing. We have studied the use of fluorescence image-guided surgery and repetitive photodynamic therapy in 14 metastatic brain cancers.Methods: Case note review of prospectively collected data on patients who were treated with PDT at the time of surgery for brain metastases. Patients were consented for the surgery and PDT. Patients were given 2mg/kg body weight of Photofrin® IV 48h before the surgery and 20mg/kg 5-aminolevulenic acid orally 3h before surgery. Following resection of the tumor using fluorescence, microsurgical and image guidance techniques, the post-excision cavity is filled with a balloon using 0.32% intralipid solution and up to five consecutive PDT treatments were given using 100J/cm2 Diode Laser 630nm. Patients were followed up clinically and by brain imaging every 3 months till their death.Results: Seven were lung in origin and seven of variable sources. One patient with lung metastases died of unrelated cause while the remaining six had remained free from brain disease till their death. Two of the remaining seven patients died of local brain recurrence, one bowel after 4 weeks and one of unknown primary after 70 weeks.Conclusion: Adjuvant repetitive PDT seems to offer an excellent local control of metastatic brain carcinomas with about 79% of patients succumb to the primary and only two out of fourteen died of brain recurrence with the best results obtained in lung cancer.Photodynamic therapy adjuvant to surgery in metastatic carcinoma in brainF. Aziz, S. Telara, H. Moseley, C. Goodman, P. Manthri, M. Sam Eljamel10.1016/j.pdpdt.2009.09.003Photodiagnosis and Photodynamic Therapy 6, 3 (2009)2009-11-16Photodiagnosis and Photodynamic Therapy2009-11-1663-4S1572-1000(09)X0005-0Articles227230http://www.pdpdt-journal.com/article/PIIS1572100009001367/abstract?rss=yesThe future of PDT will build on our scientific and clinical success, expand to new horizons but, most importantly, will question and, I believe, significantly modify what we currently accept and term PDT.Future PDTRon R. Allison10.1016/j.pdpdt.2009.10.003Photodiagnosis and Photodynamic Therapy 6, 3 (2009)2009-11-20Photodiagnosis and Photodynamic Therapy2009-11-2063-4S1572-1000(09)X0005-0Articles231234http://www.pdpdt-journal.com/article/PIIS1572100009001331/abstract?rss=yesChondrosarcoma is a malignancy that is cartilaginous in origin and represents approximately 25% of all primary osseous neoplasms. Chondrosarcomas are rare with 90 new cases a year reported in the UK. Of these, only 10% occur in the head and neck. Peak incidence is between the ages of 30–50, with no apparent correlation with gender .Chondrosarcoma of the hyoid treated with interstitial photodynamic therapy: Case studyFarai Nhembe, Waseem Jerjes, Tahwinder Upile, Zaid Hamdoon, Colin Hopper10.1016/j.pdpdt.2009.09.004Photodiagnosis and Photodynamic Therapy 6, 3 (2009)2009-11-20Photodiagnosis and Photodynamic Therapy2009-11-2063-4S1572-1000(09)X0005-0Articles235237http://www.pdpdt-journal.com/article/PIIS1572100009001380/abstract?rss=yesPDT in the UK; when will the NHS see the light? Photodynamic Therapy Workshop London 28th September 200910.1016/j.pdpdt.2009.10.005Photodiagnosis and Photodynamic Therapy 6, 3 (2009)2009-11-16Photodiagnosis and Photodynamic Therapy2009-11-1663-4S1572-1000(09)X0005-0News and Views238239http://www.pdpdt-journal.com/article/PIIS1572100009001343/abstract?rss=yesThis joint meeting began with an opening ceremony on September 4th in the magnificent Aula of the University of Wroclaw. Professor Piotr Ziolkowski, Chairman of the local organising committee welcomed delegates and guests, following which there was a reception in which all present had the opportunity to renew old friendships.EPPM-2 conference report: The 2nd Conference of the European Platform for Photodynamic Medicine (EPPM) in conjunction with the 13th Bi Annual Congress of the European Society for Photobiology (ESP), 5th–10th September 2009, WroclawKate Dixon10.1016/j.pdpdt.2009.10.001Photodiagnosis and Photodynamic Therapy 6, 3 (2009)2009-11-09Photodiagnosis and Photodynamic Therapy2009-11-0963-4S1572-1000(09)X0005-0News and Views240242http://www.pdpdt-journal.com/article/PIIS1572100009001392/abstract?rss=yesList of Reviewers Volume 6, 200910.1016/j.pdpdt.2009.10.006Photodiagnosis and Photodynamic Therapy 6, 3 (2009)2009-11-20Photodiagnosis and Photodynamic Therapy2009-11-2063-4S1572-1000(09)X0005-0Acknowledgement243243