scholarly journals STMO-17 Treatment outcome of photodynamic therapy using talaporfin sodium for recurrent high-grade glioma

2021 ◽  
Vol 3 (Supplement_6) ◽  
pp. vi14-vi14
Author(s):  
Makoto Ohno ◽  
Daisuke Kawauchi ◽  
Yoshiharu Hayashi ◽  
Kaishi Satomi ◽  
Yasuji Miyakita ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Treatment Outcome ◽  
Treatment Outcomes ◽  
High Grade Glioma ◽  
Local Tumor Control ◽  
Tumor Control ◽  
High Grade ◽  
Local Tumor ◽  
Limit Of Quantification ◽  
Talaporfin Sodium

Abstract Objective: Photodynamic therapy (PDT) using Talaporfin Sodium (TS) is a novel therapeutic strategy to improve local tumor control in high-grade glioma. TS is a photosensitizer that accumulates in tumor cells and produces highly toxic free radicals by intraoperative irradiation of laser with a 664nm wavelength. However, little is known about the treatment outcomes of PDT in recurrent high-grade gliomas (rHGG). In this study, we investigated the treatment outcome of PDT in rHGG and evaluated the correlation between intratumoral TS accumulation and outcomes. Methods: We included 21 patients with rHGG and 22 tumors, who were treated by PDT between June 2016 and March 2021. TS was transvenously administered 22–26 hours before PDT. Intratumoral TS concentrations were measured by liquid chromatography using frozen tissue. Results: The rHGGs included 10 glioblastoma, IDH1/2-wildtype (GBM, IDH1/2-WT: 45.5%), 3 GBM, IDH1/2-mutant (GBM, IDH1/2-Mut: 13.6%), 7 anaplastic oligodendroglioma, IDH1/2-Mut/codel (AO, IDH1/2-Mut/codel: 31.8%), 1 anaplastic astrocytoma, IDH1/2-WT (AA, IDH1/2-WT: 4.5%), 1 high-grade astrocytoma, IDH1/2-WT (4.5%). The median local progression free survival (PFS) time after PDT was 3.6 months and the median survival time from PDT was 19.4 months. The intratumoral TS concentrations of 7 tumors (TS(-): 31.8%) were below the limit of quantification, and the intratumoral TS concentrations of the remaining 15 tumors (TS(+)) were 43.5 ng/mg-protein (14.7–132 ng/mg-protein). The intratumoral TS concentrations were not significantly associated with IDH1/2 mutation status, cellularity, tumor grade, and pattern of enhancement. The median PFS from PDT tended to be longer in TS(+) than in TS(-) (TS(+): 6.3 vs TS(-): 1.4 months, p = 0.054). Conclusions: We found that the intratumoral TS concentrations were heterogeneous and 31.8% were below the limit of quantification. TS(+) tended to have better local tumor control than TS(-), suggesting the intratumoral TS accumulation have an impact of treatment outcomes of PDT.

scholarly journals Combination of ALA-induced fluorescence-guided resection and intraoperative open photodynamic therapy for recurrent glioblastoma: case series on a promising dual strategy for local tumor control

2020 ◽  
pp. 1-11 ◽  
Author(s):  
Stephanie Schipmann ◽  
Michael Müther ◽  
Louise Stögbauer ◽  
Sebastian Zimmer ◽  
Benjamin Brokinkel ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Aminolevulinic Acid ◽  
Diffusion Tensor ◽  
Case Series ◽  
Local Tumor Control ◽  
Resection Margins ◽  
Tumor Control ◽  
Therapeutic Effects ◽  
Local Tumor ◽  
Continuous Irrigation

OBJECTIVEHigh-grade glioma (HGG) prognosis remains dismal, with inevitable, mostly local recurrence. Regimens for improving local tumor control are therefore needed. Photodynamic therapy (PDT) using porfimer sodium has been investigated but was abandoned due to side effects and lack of survival benefits. Intracellular porphyrins induced by 5-aminolevulinic acid (5-ALA) are approved for fluorescence-guided resections (FGRs), but are also photosensitizers. Activated by light, they generate reactive oxygen species with resultant cytotoxicity. The authors present a combined approach of 5-ALA FGR and PDT.METHODSAfter 5-ALA FGR in recurrent HGG, laser diffusors were strategically positioned inside the resection cavity. PDT was applied for 60 minutes (635 nm, 200 mW/cm diffusor, for 1 hour) under continuous irrigation for maintaining optical clarity and ventilation with 100% oxygen. MRI was performed at 24 hours, 14 days, and every 3 months after surgery, including diffusion tensor imaging and apparent diffusion coefficient maps.RESULTSTwenty patients were treated. One surgical site infection after treatment was noted at 6 months as the only adverse event. MRI revealed cytotoxic edema along resection margins in 16 (80%) of 20 cases, mostly annular around the cavity, corresponding to prior laser diffusor locations (mean volume 3.3 cm3). Edema appeared selective for infiltrated tissue or nonresected enhancing tumor. At the 14-day follow-up, enhancement developed in former regions of edema, in some cases vanishing after 4–5 months. Median progression-free survival (PFS) was 6 months (95% CI 4.8–7.2 months).CONCLUSIONSCombined 5-ALA FGR and PDT provides an innovative and safe method of local tumor control resulting in promising PFS. Further prospective studies are warranted to evaluate long-term therapeutic effects.

scholarly journals A Comparison of Dose Metrics to Predict Local Tumor Control for Photofrin-mediated Photodynamic Therapy

2017 ◽  
Vol 93 (4) ◽  
pp. 1115-1122 ◽  
Author(s):  
Haixia Qiu ◽  
Michele M. Kim ◽  
Rozhin Penjweini ◽  
Jarod C. Finlay ◽  
Theresa M. Busch ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Local Tumor Control ◽  
Tumor Control ◽  
Local Tumor ◽  
Dose Metrics

scholarly journals Laparoscopic Liver Resection versus Percutaneous Radiofrequency Ablation for Small Single Nodular Hepatocellular Carcinoma: Comparison of Treatment Outcomes

Liver Cancer ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 25-37
Author(s):  
Dong Ho Lee ◽  
Jing Woong Kim ◽  
Jeong Min Lee ◽  
Jong Man Kim ◽  
Min Woo Lee ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Liver Resection ◽  
Treatment Outcomes ◽  
Cumulative Incidence ◽  
Laparoscopic Liver Resection ◽  
Local Tumor Control ◽  
Treatment Modalities ◽  
Tumor Control ◽  
Percutaneous Radiofrequency Ablation ◽  
Local Tumor

<b><i>Background:</i></b> Treatment outcomes of laparoscopic liver resection (LLR) and percutaneous radiofrequency ablation (p-RFA) for small single hepatocellular carcinomas (HCCs) have not yet been fully compared. The aim of this study was to compare LLR and p-RFA as first-line treatment options in patients with single nodular HCCs ≤3 cm. <b><i>Methods:</i></b> From January 2014 to December 2016, a total of 566 patients with single nodular HCC ≤3 cm treated by either LLR (<i>n</i> = 251) or p-RFA (<i>n</i> = 315) were included. The recurrence-free survival (RFS) and cumulative incidence of local tumor progression (LTP) were estimated using Kaplan-Meier methods and compared using the log-rank test. Treatment outcome of 2 treatment modalities was compared in the subgroup of patients according to the tumor location. <b><i>Results:</i></b> There were no significant differences in overall survival between LLR and p-RFA (<i>p</i> = 0.160); however, 3-year RFS was demonstrated to be significantly higher after LLR (74.4%) than after p-RFA (66.0%) (<i>p</i> = 0.013), owing to its significantly lower cumulative incidence of LTP (2.1% at 3 years after LLR vs. 10.0% after p-RFA, <i>p</i> &#x3c; 0.001). The complication rate of p-RFA was significantly lower than that of LLR (5.1 vs. 10.0%, <i>p</i> = 0.026). LLR also provided significantly better local tumor control than p-RFA for subscapular tumors (3-year LTP rates: 1.9 vs. 8.8%, <i>p</i> = 0.012), perivascular tumors (3-year LTP rates: 0.0 vs. 17.2%, <i>p</i> = 0.007), and tumors located in anteroinfero-lateral liver portions (3-year LTP rates: 0.0 vs. 10.7%, <i>p</i> &#x3c; 0.001). However, there were no significant differences in LTP rates between LLR and p-RFA for non-subcapsular and non-perivascular tumors (<i>p</i> = 0.482) and for tumors in postero-superior liver portions (<i>p</i> = 0.380). <b><i>Conclusions:</i></b> LLR can provide significantly better local tumor control than p-RFA for small single HCCs in subcapsular, perivascular, and anteroinferolateral liver portions and thus may be the preferred treatment option for these tumors.

Stereotactic Radiosurgery for Choroid Plexus Tumors: A Report of the International Radiosurgery Research Foundation

Neurosurgery ◽  
2020 ◽  
Author(s):  
Andrew Faramand ◽  
Hideyuki Kano ◽  
Ajay Niranjan ◽  
Ahmet F Atik ◽  
Cheng-chia Lee ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Choroid Plexus ◽  
Local Tumor Control ◽  
Tumor Control ◽  
Low Grade ◽  
High Grade ◽  
Local Tumor ◽  
Who Grade ◽  
Choroid Plexus Tumors ◽  
Significant Difference

Abstract BACKGROUND Choroid plexus tumors (CPT) are rare epithelial tumors of the choroid plexus. Gross total resection (GTR) may be curative, but it is not always possible. OBJECTIVE To evaluate the role of Gamma Knife stereotactic radiosurgery (GKSRS) as either a primary or adjuvant management option for WHO grade I-III CPT through a multicenter project. METHODS A total of 32 patients (20 females) with a total of 43 treated tumors were included in the analysis. A total of 25 patients (78%) had undergone initial surgical resection. The median total tumor volume was 2.2 cc, and the median margin and maximum doses were 13 and 25.5 Gy, respectively. RESULTS Local tumor control was achieved in 69% of cases. Local tumor progression-free survival (PFS) rate for low-grade tumors at 1, 3, and 5 yr was 90%, 77%, 58%, respectively. The actuarial local tumor PFS rate for high-grade tumors at 1, 3, and 5 yr was 77%, 62%, and 62%, respectively. There was no significant difference in local tumor control rates between low- and high-grade CPT (P = .3). Gender, age, and degree of resection were not associated with treated tumor PFS. Distant intracranial spread developed in 6 patients at a median of 22 mo after initial SRS. Actuarial distant brain tumor PFS rate at 1, 2, 5, and 10 yr was 93%, 88%, 78%, and 65%, respectively. Three patients (9%) developed persistent symptomatic adverse radiation effects at a median of 11 mo after the procedure. CONCLUSION GKSRS represents a minimally invasive alternative management strategy for imaging defined or surgically recurrent low- and high-grade CPT.

scholarly journals Association between Time to Local Tumor Control and Treatment Outcomes Following Repeated Loco-Regional Treatment Session in Patients with Hepatocellular Carcinoma: A RETROSPECTIVE, Single-Center Study

Life ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1062
Author(s):  
Krzysztof Bartnik ◽  
Wacław Hołówko ◽  
Olgierd Rowiński
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Outcomes ◽  
Independent Predictor ◽  
Univariate Analysis ◽  
Progression Free Survival ◽  
Local Tumor Control ◽  
Primary Study ◽  
Tumor Control ◽  
Local Tumor ◽  
Regional Treatment

Background: Whether the number of loco-regional treatment sessions and the time required to obtain local tumor control (LTC) affects the prognosis of patients with hepatocellular carcinoma (HCC) remains controversial. This study aimed to determine whether a longer time to LTC is a significant and independent predictor of poor treatment outcomes. Methods: In this retrospective study, we analyzed data of 139 treatment-naive patients with HCC who were not eligible for a treatment other than transarterial chemoembolization (TACE) at baseline. The outcome analyses were performed using the Cox proportional hazard model and Kaplan–Meier method, while the overall survival (OS) and progression free survival (PFS) were the primary study endpoints. Results: Overall, LTC was achieved in 82 (59%) of patients, including 67 (81%) patients who achieved LTC following TACE sessions alone and 15 (19%) subjects required additional ablation session. The median OS did not differ significantly between groups that needed 2, 3, or >3 locoregional treatment sessions to achieve LTC (p = 0.37). Longer time to LTC (in weeks) was significantly associated with shorter OS in univariate analysis (p = 0.04), but not in an adjusted model (p = 0.14). Both univariate and adjusted analyses showed that longer time to reach LTC was significantly associated with shorter PFS (adjusted HR = 1.04, 95% CI 1.001–1.09, p = 0.048). Conclusions: These findings show that the longer time to LTC is not an independent predictor of OS, but suggest that PFS may be significantly shorter in patients with longer time to LTC.

Sign in / Sign up

Export Citation Format

Share Document