ACTR-90. ROLE OF PHOTODYNAMIC THERAPY (PDT) USING TALAPORFIN SODIUM AND SEMICONDUCTOR LASER ON PROGNOSIS OF PATIENTS WITH NEWLY DIAGNOSED GLIOBLASTOMA

OBJECTIVEIn this study on the effectiveness and safety of photodynamic therapy (PDT) using talaporfin sodium and a semiconductor laser, the long-term follow-up results of 11 patients with glioblastoma enrolled in the authors’ previous phase II clinical trial (March 2009–2012) and the clinical results of 19 consecutive patients with newly diagnosed glioblastoma prospectively enrolled in a postmarket surveillance (March 2014–December 2016) were analyzed and compared with those of 164 patients treated without PDT during the same period.METHODSThe main outcome measures were the median overall survival (OS) and progression-free survival (PFS) times. Moreover, the adverse events and radiological changes after PDT, as well as the patterns of recurrence, were analyzed and compared between the groups. Kaplan-Meier curves were created to assess the differences in OS and PFS between the groups. Univariate and multivariate analyses were performed to identify the prognostic factors, including PDT, among patients with newly diagnosed glioblastoma.RESULTSThe median PFS times of the PDT and control groups were 19.6 and 9.0 months, with 6-month PFS rates of 86.3% and 64.9%, respectively (p = 0.016). The median OS times were 27.4 and 22.1 months, with 1-year OS rates of 95.7% and 72.5%, respectively (p = 0.0327). Multivariate analyses found PDT, preoperative Karnofsky Performance Scale score, and IDH mutation to be significant independent prognostic factors for both OS and PFS. Eighteen of 30 patients in the PDT group experienced tumor recurrence, including local recurrence, distant recurrence, and dissemination in 10, 3, and 4 patients, respectively. Conversely, 141 of 164 patients in the control group experienced tumor recurrence, including 101 cases of local recurrence. The rate of local recurrence tended to be lower in the PDT group (p = 0.06).CONCLUSIONSThe results of the present study suggest that PDT with talaporfin sodium and a semiconductor laser provides excellent local control, with few adverse effects even in cases of multiple laser irradiations, as well as potential survival benefits for patients with newly diagnosed glioblastoma.

Download Full-text

Evaluation of photodynamic therapy with talaporfin sodium on relapse controlling efficacy at laser irradiation sites in newly diagnosed glioblastoma

Photodiagnosis and Photodynamic Therapy ◽

10.1016/j.pdpdt.2015.07.016 ◽

2015 ◽

Vol 12 (3) ◽

pp. 327

Author(s):

Takashi Maruyama ◽

Soko Ikuta ◽

Masayuki Nitta ◽

Yoshihiro Muragaki ◽

Hiroshi Iseki

Keyword(s):

Photodynamic Therapy ◽

Laser Irradiation ◽

Newly Diagnosed ◽

Talaporfin Sodium ◽

Newly Diagnosed Glioblastoma

Download Full-text

Phase II clinical study on intraoperative photodynamic therapy with talaporfin sodium and semiconductor laser in patients with malignant brain tumors

Journal of Neurosurgery ◽

10.3171/2013.7.jns13415 ◽

2013 ◽

Vol 119 (4) ◽

pp. 845-852 ◽

Cited By ~ 102

Author(s):

Yoshihiro Muragaki ◽

Jiro Akimoto ◽

Takashi Maruyama ◽

Hiroshi Iseki ◽

Soko Ikuta ◽

...

Keyword(s):

Photodynamic Therapy ◽

Brain Tumors ◽

Semiconductor Laser ◽

Positive Impact ◽

Radiation Power ◽

Combined Treatment ◽

Tumor Control ◽

Study Cohort ◽

Newly Diagnosed ◽

Talaporfin Sodium

Object The objective of the present study was to perform a prospective evaluation of the potential efficacy and safety of intraoperative photodynamic therapy (PDT) using talaporfin sodium and irradiation using a 664-nm semiconductor laser in patients with primary malignant parenchymal brain tumors. Methods In 27 patients with suspected newly diagnosed or recurrent primary malignant parenchymal brain tumors, a single intravenous injection of talaporfin sodium (40 mg/m2) was administered 1 day before resection of the neoplasm. The next day after completion of the tumor removal, the residual lesion and/or resection cavity were irradiated using a 664-nm semiconductor laser with a radiation power density of 150 mW/cm2 and a radiation energy density of 27 J/cm2. The procedure was performed 22–27 hours after drug administration. The study cohort included 22 patients with a histopathologically confirmed diagnosis of primary malignant parenchymal brain tumor. Thirteen of these neoplasms (59.1%) were newly diagnosed glioblastomas multiforme (GBM). Results Among all 22 patients included in the study cohort, the 12-month overall survival (OS), 6-month progression-free survival (PFS), and 6-month local PFS rates after surgery and PDT were 95.5%, 91%, and 91%, respectively. Among patients with newly diagnosed GBMs, all these parameters were 100%. Side effects on the skin, which could be attributable to the administration of talaporfin sodium, were noted in 7.4% of patients and included rash (2 cases), blister (1 case), and erythema (1 case). Skin photosensitivity test results were relatively mild and fully disappeared within 15 days after administration of photosensitizer in all patients. Conclusions Intraoperative PDT using talaporfin sodium and a semiconductor laser may be considered as a potentially effective and sufficiently safe option for adjuvant management of primary malignant parenchymal brain tumors. The inclusion of intraoperative PDT in a combined treatment strategy may have a positive impact on OS and local tumor control, particularly in patients with newly diagnosed GBMs. Clinical trial registration no.: JMA-IIA00026 (https://dbcentre3.jmacct.med.or.jp/jmactr/App/JMACTRS06/JMACTRS06.aspx?seqno=862).

Download Full-text

The Prognostic Role of Peritumoral Edema in Patients with Newly Diagnosed Glioblastoma: A Retrospective Analysis

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2021.04.042 ◽

2021 ◽

Vol 89 ◽

pp. 249-257

Author(s):

Meng Zhang ◽

Fuyue Ye ◽

Meng Su ◽

Meng Cui ◽

Hongzun Chen ◽

...

Keyword(s):

Retrospective Analysis ◽

Peritumoral Edema ◽

Newly Diagnosed ◽

Prognostic Role ◽

Newly Diagnosed Glioblastoma

Download Full-text

PC3 - 152 Impact of Extent of Resection Upon Outcome in Newly Diagnosed Glioblastoma: A Study in the Molecular Era

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2016.380 ◽

2016 ◽

Vol 43 (S4) ◽

pp. S17-S18

Author(s):

W.M.H. Sayeed ◽

E. Batuyong ◽

J.C. Easaw ◽

M. Pitz ◽

J.J.P. Kelly

Keyword(s):

Multivariable Analysis ◽

Extent Of Resection ◽

Postal Code ◽

Newly Diagnosed ◽

Presenting Symptoms ◽

Tumour Location ◽

Newly Diagnosed Glioblastoma ◽

Molecular Marker Analysis

For decades, debate has persisted regarding the role of surgical resection in newly diagnosed glioblastoma. There is increasing evidence that extent of resection (EoR) is an independent prognostic factor. Previous work has proposed the inclusion of EoR in a risk stratification algorithm but does not incorporate account recent advances in the molecular characterization of tumours. We set out to investigate the effect of EoR on overall survival (OS), and to develop a stratification algorithm incorporating both EoR and modern molecular markers for prognostication. HYPOTHESIS: Greater EoR is independently associated with improved OS. METHODS: We examined 190 consecutive cases of histopathologically confirmed newly-diagnosed glioblastoma who were operated upon between January 1, 2012 and December 31, 2014. Variables including age, sex, postal code, KPS, tumour location, presenting symptoms, treatment history, date of progression, date of reoperation, as well as MGMT, IDH, 1p/19q codeletion, and ATRX status were recorded. Preoperative and postoperative MRIs were reviewed and volumetric tumour burden will be analyzed and EoR will be calculated. RESULTS: Preliminary EoR calculations (n=18) show a positive correlation between EoR and OS. CONCLUSION: A correlation exists between EoR and OS, although multivariable analysis is planned to exclude potential confounders. MRI review, chart review including molecular marker analysis and EoR calculations are ongoing.

Download Full-text

The role of temozolomide in newly-diagnosed glioblastoma multiforme

British Journal of Neurosurgery ◽

10.1080/02688690802182314 ◽

2008 ◽

Vol 22 (3) ◽

pp. 456-456

Author(s):

Michael D. Jenkinson

Keyword(s):

Glioblastoma Multiforme ◽

Newly Diagnosed ◽

Newly Diagnosed Glioblastoma

Download Full-text

ACTR-39. PHOTODYNAMIC THERAPY USING TALAPORFIN SODIUM AND SEMICONDUCTOR LASER COMBINED WITH MAXIMUM TUMOR RESECTION IMPROVES PROGNOSIS OF PATIENTS WITH GLIOBLASTOMA

Neuro-Oncology ◽

10.1093/neuonc/now212.037 ◽

2016 ◽

Vol 18 (suppl_6) ◽

pp. vi10-vi10

Author(s):

Masayuki Nitta ◽

Yoshihiro Muragaki ◽

Takashi Maruyama ◽

Soko Ikuta ◽

Hiroshi Iseki ◽

...

Keyword(s):

Photodynamic Therapy ◽

Semiconductor Laser ◽

Tumor Resection ◽

Talaporfin Sodium

Download Full-text

Surgical management of newly diagnosed glioblastoma in adults: role of cytoreductive surgery

Journal of Neuro-Oncology ◽

10.1007/s11060-008-9614-5 ◽

2008 ◽

Vol 89 (3) ◽

pp. 271-286 ◽

Cited By ~ 39

Author(s):

Timothy C. Ryken ◽

Bruce Frankel ◽

Terrance Julien ◽

Jeffrey J. Olson

Keyword(s):

Surgical Management ◽

Cytoreductive Surgery ◽

Newly Diagnosed ◽

Newly Diagnosed Glioblastoma

Download Full-text

Role of 11C Methionine Positron Emission Tomography (11CMETPET) for Surgery and Radiation Therapy Planning in Newly Diagnosed Glioblastoma Patients Enrolled into a Phase II Clinical Study

Journal of Clinical Medicine ◽

10.3390/jcm10112313 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2313

Author(s):

Federico Pessina ◽

Pierina Navarria ◽

Elena Clerici ◽

Luisa Bellu ◽

Andrea Franzini ◽

...

Keyword(s):

Radiation Therapy ◽

Surgical Resection ◽

Karnofsky Performance Scale ◽

Newly Diagnosed ◽

Patients Âgés ◽

Volume Delineation ◽

Methionine Uptake ◽

Newly Diagnosed Glioblastoma ◽

Extent Of Surgical Resection

(1) Background: We investigated the role of [11C]-methionine PET in a cohort of newly diagnosed glioblastoma multiforme (GBM) patients to evaluate whether it could modify the extent of surgical resection and improve radiation therapy volume delineation. (2) Methods: Newly diagnosed GBM patients, ages 18–70, with a Karnofsky performance scale (KPS) ≥ 70 with available MRI and [11C]-methionine PET were included. Patients were treated with different amounts of surgical resection followed by radio-chemotherapy. The role of [11C]-methionine PET in surgical and RT planning was analyzed. A threshold of SUVmax was searched. (3) Results: From August 2013 to April 2016, 93 patients were treated and included in this analysis. Residual tumor volume was detected in 63 cases on MRI and in 78 on [11C]-methionine PET, including 15 receiving gross total resection. The location of uptake was mainly observed in FLAIR abnormalities. [11C]-methionine uptake changed RT volume in 11% of patients. The presence of [11C]-methionine uptake in patients receiving GTR proved to influence survival (p = 0.029). The threshold of the SUVmax conditioning outcome was five. (4) Conclusions: [11C]-methionine PET allowed to detect areas at higher risk of recurrence located in FLAIR abnormalities in patients affected by GBM. A challenging issue is represented by integrating morphological and functional imaging to better define the extent of surgical resection to perform.

Download Full-text