Photodynamic therapy for preinvasive vaginal cancer.

5592 Background: Photodynamic therapy (PDT) is an effective method for the treatment of various cancers resulting in apoptosis, autophagy and ischemic necrosis of irradiated tissues. The purpose of the study was to analyze the efficacy of PDT for pre-invasive vaginal cancer treatment. Methods: PDT results were studied in 20 patients aged 32-65 years with verified pre-invasive vaginal cancer. All patients received PDT with the Latus diode laser and Photolon or Photolan photosensitizers. The effect was evaluated with extended colposcopy. The criteria for efficiency included normalization of the colposcopic picture and the absence of atypical cells. The sizes of the irradiation fields varied from 1.5 to 2 cm, the number of fields - from 1 to 4, the power density - from 0.1 to 0.17 W/cm2, the light dose - from 40 to 100 J/cm2. The duration of a PDT session varied from 10 to 30 min, depending on the number of irradiation fields. The irradiation field necessarily included an area of normal tissue 3-5 mm surrounding the lesion. 4 to 6 sessions were required to restore the normal layer of stratified squamous epithelium. The antitumor efficacy of PDT was evaluated based on the results of visual observation of changes in the area of the treated pathological foci and information on the presence or absence of clinical symptoms of the disease 1 and 3 months after the treatment (WHO criteria). Results: Complete regression was registered in 100% of patients after 3 months. Repeated courses of PDT were required in cases with a wide spread of pathological foci and the impossibility of their simultaneous irradiation. At follow-up after 1 month, 3 of 20 patients (15%) showed local foci of atypical changes in the epithelium managed with repeated PDT courses. In 6 months, stable remission of the disease clinical symptoms in the treated pathological foci was registered. The results of the cytological study performed 3 months after PDT were normal in 100% patients; no negative changes were registered 6 and 12 months after PDT. Conclusions: The results of PDT in the treatment of patients with pre-invasive vaginal cancer demonstrated its high therapeutic efficacy and a minimal number of adverse reactions, which allows recommending PDT in the treatment of pre-invasive vaginal cancer.

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A Case of Photodynamic Therapy for Advanced Adenocarcinoma of Esophagogastric Junction

Journal of Clinical and Nursing Research ◽

10.26689/jcnr.v4i6.1620 ◽

2020 ◽

Vol 4 (6) ◽

Author(s):

Wanlu Cai ◽

Xiaoxiong Hu ◽

Jianwen Sheng ◽

Huizhen Fan

Keyword(s):

Adverse Reaction ◽

Photodynamic Therapy ◽

Elderly Patients ◽

Esophagogastric Junction ◽

Adverse Reactions ◽

Clinical Symptoms ◽

Gastric Fundus ◽

High Repetition Rate ◽

Invasive Technique ◽

Short Term

Photodynamic therapy (PDT) is a new minimally invasive technique for the treatment of tumors. Compared with traditional treatments such as surgery, radiotherapy and chemotherapy, PDT has the advantages of targeted killing of primary and recurrent tumor cells, less damage to surrounding normal tissue, less complications and high repetition rate. The purpose of this study was to investigate the short-term efficacy and adverse reactions of photodynamic therapy in advanced elderly patients with esophageal-gastric junction adenocarcinoma without surgical indications. A patient with advanced adenocarcinoma of esophagus and fundus was treated with photodynamic therapy under gastroscope. Intravenous drip of Cipofen (hematoporphyrin injection 150mg / 0.9% saline 250ml) for 1 hour to keep the patient away from light.48 hours after administration, photodynamic therapy was performed with "Leimai" PDT630-A photodynamic therapy apparatus, 3cm columnar optical fiber, laser treatment wavelength of 630nm, transmission efficiency of 0.70, output power of 1.4W, irradiation at the lower segment of the esophagus and cardia for 150s. The curative effect was evaluated by comparing gastroscopy before and after photodynamic therapy. Before treatment, there were proliferative lesions in the lower part of esophagus and cardia, erosion and necrosis on the surface, stricture of esophageal cavity, huge ulcer near gastric fundus, filthy moss and dam-like hyperplasia and eminence of surrounding mucosa. After treatment, the local mucosa at the entrance of cardia became white and there was no bleeding. Within four days after treatment, the symptoms of nausea and vomiting disappeared; the adverse reaction of retrosternal discomfort began to occur on the second day after operation, and the adverse reaction was not improved after photodynamic therapy. Photodynamic therapy has a significant short-term effect on advanced elderly patients with adenocarcinoma of the esophagogastric junction, which can significantly alleviate the clinical symptoms and relieve the pain of the patients. However, the adverse reactions can not be ignored. Therefore, photodynamic targeting therapy for tumor needs to be further studied. It is believed that with the continuous development of high-performance photosensitizers and new generation lasers, and the continuous progress of endoscopy and image guidance technology, photodynamic therapy will become an important adjuvant or palliative treatment for tumor prevention and treatment.

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COMPARATIVE STUDIES OF EFFICACY OF PHOTODYNAMIC THERAPY AND CRYOTHERAPY FOR TREATMENT OF ACTINIC KERATOSIS

Biomedical Photonics ◽

10.24931/2413-9432-2016-5-3-19-29 ◽

2016 ◽

Vol 5 (3) ◽

pp. 19-29

Author(s):

T. E. Sukhova ◽

K. A. Changlyan ◽

A. V. Molochkov ◽

V. A. Molochkov ◽

S. V. Korenev ◽

...

Keyword(s):

Photodynamic Therapy ◽

Actinic Keratosis ◽

Adverse Reactions ◽

Long Term Results ◽

Patient Treatment ◽

Control Group ◽

Study Group ◽

Complete Regression ◽

Free Survival

The results of a study on the eﬀectiveness of photodynamic therapy with a photosensitizer fotoditazin and cryotherapy for actinic keratosis are represented in the article. The study included 80 patients with 215 lesions, among them erythematous form of actinic keratosis was diagnosed in 151 (70.2%) cases, hyperkeratotic form – in 46 (21.4%) cases, a pigmented form – in 12 (5.6%) and an atypical variant of the disease – in 6 (2.8%) cases. According to histological type the distribution of tumor was as follows: 19 (54.3%) cases were diagnosed as hypertrophic type, 6 (17.1%) – atrophic, 8 (22.9%) – bowenoid and 2 (5.7% ) – pigmented type. Patients from the study group received one session of photodynamic therapy using laser unit "LAMI" (662 nm) after 2 hours of application of fotoditazin 0.5% gel at dose of 0,2-0,3 ml per 1 cm2 of actinic keratosis focus with the following parameters: the energy density of the laser radiation – 200 J/cm2, power density – 0.14–0.48 W/cm2. In the control group patients underwent cryotherapy with liquid nitrogen with an exposure of 30-60 sec. The comparative analysis of the immediate results showed a tendency for the efficacy of photodynamic therapy to increase (the rate of complete regression was 92.5%) compared with cryotherapy (85.0%) (p>0,05). There were also a tendency for long-term results after photodynamic therapy to improve: three-year recurrence-free survival was 94.6% and 88.2%, respectively. For the photodynamic therapy there were signiﬁcantly fewer adverse reactions, the epithelization time in lesions was signiﬁcantly shorter. Compared with cryotherapy the photodynamic therapy provided signiﬁcantly better cosmetic results (p <0.01), and can be used for out-patient treatment of patients with actinic keratosis.><0.01) and can be used for out-patient treatment of patients with actinic keratosis.

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Photodynamic therapy for vulvar leukoplakia

Biomedical Photonics ◽

10.24931/2413-9432-2018-7-4-4-10 ◽

2019 ◽

Vol 7 (4) ◽

pp. 4-10 ◽

Cited By ~ 1

Author(s):

T. Р. Artemyeva ◽

D. A. Tzerkovsky

Keyword(s):

Photodynamic Therapy ◽

Semiconductor Laser ◽

Power Density ◽

Intravenous Injection ◽

Adverse Reactions ◽

Results Of Treatment ◽

Dynamic Therapy ◽

Therapy Sessions ◽

Photo Dynamic Therapy

The aim of study is to evaluate the tolerability and eﬀectiveness of photodynamic therapy as an organ‑preserving treatment in patients with vulvar leukoplakia. 50 patients with a verifed diagnosis of «vulvar leukoplakia» were included in the study. The age varied from 27 to 74 years. The method of treatment assumed the use of the photosensitizer рhotolon (RUE «Belmedpreparaty», Belarus) administered intravenously in doses of 1.8–2.5 mg/kg. Photoirradiation of pathological foci was carried out 2.5–3 hours after intravenous injection of photolon® using a semiconductor laser «UPL PDT» (LEMT, Belarus, λ=661 nm) at exposure doses from 30 to 100 J/cm2 with a power density of 100–170 mW/cm2. The treatment was performed under medical anesthesia. The results of treatment were evaluated using clinical data. Adverse reactions and complications after the introduction of the photosensitizer and photoirradiation have not been observed. Complete clinical regression of the treated pathological foci was noted in 100% of cases with a follow‑up observation 1 month after the treatment. At follow‑up after 3 months, local recurrences of the disease were detected in 4 cases, which were successfully treated with repeated photo‑dynamic therapy sessions. The percentage of complete regressions was 92%, partial – 8%. The obtained results allow judging on the possibility of using photodynamic therapy in the treatment of patients with vulvar leukoplakia, which allows to preserve the organ and obtain a satisfactory functional and cosmetic result.

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Photodynamic therapy in patients with skin metastases of disseminated melanoma

Biomedical Photonics ◽

10.24931/2413-9432-2019-8-1-24-28 ◽

2019 ◽

Vol 8 (1) ◽

pp. 24-28

Author(s):

D. A. Tzerkovsky ◽

N. A. Petrovskaya ◽

A. N. Mazurenko

Keyword(s):

Quality Of Life ◽

Photodynamic Therapy ◽

Semiconductor Laser ◽

Power Density ◽

Tumor Volume ◽

Complete Regression ◽

Skin Melanoma ◽

Who Criteria

The aim of the study was to evaluate the immediate results of photodynamic therapy (PDT) in patients with intradermal metastases of skin melanoma. The study included 50 patients who received treatment at the department of hyperthermia and photodynamic therapy. The study included 23 (46%) men and 27 (54%) women with an average age of 60.7±10.4 years. PDT of tumors was carried out 3–4 hours after intravenous administration of a chlorine-based photosensitizer (Photolon) in doses of 1.5–3 mg/kg using a semiconductor laser «UPL-PDT» (Lemt, Belarus, λ=660±5 nm). The exposure doses varied from 100 to 400 J/cm2; power density – from 0.2 to 0.9 W/cm2; power – from 0.25 to 1 W and time of PDT of one focus was dependent on the size and location of the tumor and was 5 to 20 minutes. Evaluation of antitumor efficacy of PDT was carried out according to WHO criteria. The terms of follow-up of patients were between 3 and 23 months. At follow-up observation, 1–3 months after the treatment, complete regression of intradermal metastases of skin melanoma was achieved in 9 (18%) patients, partial – in 28 (56%), process stabilization in 8 (16%) and progression in 5 (10%)) patients. The objective effect was achieved in 74% of patients, the therapeutic – in 90%. PDT can be used in the treatment of intradermal metastases of disseminated skin melanoma with palliative purposes and allows reducing the tumor volume, which significantly improves the quality of life of patients.

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The Combination of Antimicrobial Photodynamic Therapy and Photobiomodulation Therapy for the Treatment of Palatal Ulcers: A Case Report

Journal of lasers in medical sciences ◽

10.34172/jlms.2020.38 ◽

2020 ◽

Vol 11 (2) ◽

pp. 228-233

Author(s):

Rafael Maya ◽

Lorena Lúcia Costa Ladeira ◽

Juliana Elaine Pinto Maya ◽

Letícia Machado Gonçalves Mail ◽

Sandra Kalil Bussadori ◽

...

Keyword(s):

Photodynamic Therapy ◽

Case Report ◽

Clinical Symptoms ◽

Bacterial Load ◽

Healing Process ◽

Tissue Expander ◽

Photobiomodulation Therapy ◽

Antimicrobial Photodynamic Therapy ◽

Tooth Tissue

Introduction: One of the unexpected side effects of the Haas type palatal expander is ulcers progressing to necrotic lesions in the palatal area due to poor hygiene. The use of antibiotic therapy is mandatory. However, long periods of healing/pain and the need for a systemic host response with the aid of metabolization, especially in children, are issues that should be taken into account in the management of this type of injury. Since phototherapy modalities (antimicrobial photodynamic therapy [aPDT] and photobiomodulation therapy [PBMT]) are able to enhance and accelerate the healing process and reduce the bacterial load, this case report aimed to describe the use of the above-mentioned therapies to treat palatal ulcers occurring during orthodontic expansion. Case Report: The patient, a 10-year-old boy, with a chief complaint of bleeding and continuous pain in the region of his expander was verified on a follow-up visit. After a dental examination, the expander was removed and two necrotic lesions which were in contact with the acrylic part of the tooth-tissue expander were found in the palatal region. The proposal was to use one aPDT session with methylene blue followed by 4 sessions of PBMT with a red laser diode. On the 5th day, reorganized tissue was verified, with the absence of bleeding, swelling, and pain. On the 20th day of follow-up, the area showed no signs of inflammation, healthy tissue without any pathological clinical symptoms, and complete wound healing. Conclusion: The concomitant use of PBMT and aPDT therapies may be considered feasible as an adjunct treatment to manage palatal ulcers resulting from the incorrect use of tooth-tissue types of expanders

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Vulvar Intraepithelial Neoplasia: Modern Views on the Problem, Management Methods (Literature Review); Own Clinical Expertise of Using the Photodynamic Method in Its Treatment

Lviv clinical bulletin ◽

10.25040/lkv2020.04.061 ◽

2020 ◽

Vol 4 (32) ◽

pp. 61-72

Author(s):

V. Dunaevska ◽

◽

T. Tatarchuk ◽

D. Tzerkovskyi ◽

◽

...

Keyword(s):

Photodynamic Therapy ◽

Clinical Symptoms ◽

Medical Science ◽

Local Treatment ◽

Pain Syndrome ◽

Intraepithelial Neoplasia ◽

Vulvar Intraepithelial Neoplasia ◽

Complete Regression ◽

Clinical Expertise ◽

Tissue Destruction

Introduction. Vulvar intraepithelial neoplasia is a precancerous pathology of the vulva and is a very important medical and social problem. All the efforts of medical science are aimed at finding and developing the latest organ-preserving methods for the treatment of vulvar intraepithelial neoplasia. One of them is photodynamic therapy-method that allows preserving the anatomical structure of the organ. The aim of the study. The aim of the article is to carry out an analytical review of the literature on modern views on the problem of vulvar intraepithelial neoplasia, methods of its management and to present the results of the own clinical expertise of using a photodynamic method for its treatment. Materials and methods. Content analysis, method of system and comparative analysis, bibliosemantic method of studying the results of current scientific research on modern views on the problem of vulvar intraepithelial neoplasia, methods of its management have been used in the article. Fifty-six literature sources in English have been studied and analyzed. The sources have been taken in the following scientometric medical databases: PubMed-NCBI, Medline, ResearchGate, CochraneLibrary, EMBASE by keywords: intraepithelial neoplasia of the vulva, vulvar intraepithelial neoplasia (VIN), photodynamic therapy (PDT), treatment of vulvar intraepithelial neoplasia; VIN treatment. The results of own clinical expertise of using the photodynamic method for vulvar intraepithelial neoplasia treatment have been described in the article as well. Results. During the PS infusion and the period before the PDT session, the general condition of the patients was satisfactory, and the symptoms of cutaneous phototoxicity, allergic reactions, which were accompanied by severe dysfunctions of vital organs, were absent after it. Despite the premedication carried out before the PDT session, the patients had moderate pain syndrome (I-II degrees) after the session as well as moderately pronounced edema in the area of pathological tissues being under the influence of photoirradiation. Within 1-5 days after treatment, the beginning of the formation of a dark brown or black area of photochemical necrosis was noted. After 3, 6 and 24 months of observation of patients with precancerosis of the vulva, remission of clinical symptoms (pruritus in the vulva) in the treated pathological foci was stated. It should be noted that the insufficient effectiveness of PDT in five cases was due to the use of subtherapeutic doses of PS “Photolon®”. During the follow-up examination at 3, 6 and 24 months in 20 out of 30 patients who received a photosensibilizer session in a subtherapeutic dose followed by photoirradiation of high power (1.0 W), both clinically and morphologically complete regression was noted being justified from both treatment and financial point of view. In the post-procedural period, all patients who were treated with PDT are recommended to: observe the light regime for 3-4 days; adequate pain relief use; hygiene; sexual rest; local treatment. Conclusions. The real advantage of photodynamic therapy associated with vulvar intraepithelial neoplasia is its ability to treat the multifocal disease with minimal tissue destruction, preservation of the vulva anatomy and excellent cosmetic results. These properties confirm the photodynamic therapy to be an effective method in vulvar intraepithelial neoplasia treatment.

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The Treatment of Macrolide-Resistant Mycoplasma Pneumoniae Pneumonia in Children

10.21203/rs.3.rs-73459/v1 ◽

2020 ◽

Author(s):

Fang-fang DAI ◽

Feng-qin LIU ◽

Xing CHEN ◽

Juan YANG ◽

Ke WANG ◽

...

Keyword(s):

Mycoplasma Pneumoniae ◽

Adverse Reactions ◽

Clinical Symptoms ◽

Gastrointestinal Symptoms ◽

Blood Parameters ◽

Oral Route ◽

Mycoplasma Pneumonia ◽

Liver And Kidney ◽

Medical University

Abstract Objective: To evaluate the efficacy and safety of levofloxacin in children with macrolide-resistant Mycoplasma pneumoniae pneumonia. Methods: We retrospectively enrolled six confirmed cases of refractory Mycoplasma pneumoniae pneumonia (n=6) who were admitted in the pediatric respiratory ward of Shandong provincial hospital Affiliated to Shandong first Medical University between January 1st, 2020and February 29th, 2020. Levofloxacin was given to the patients through the intravenous or oral route as per the following dosages :< 5 years, 8-10 mg/kg q12hours; > 5 years, 8-10 mg/kg, qd for ten days. The clinical data were collected and analyzed. Results: The average age of the enrolled cases was six years and nine months (range, four years, and seven months to eleven years and seven months). All cases were found to be drug-resistant and were treated with azithromycin combined with antibacterial drugs. Levofloxacin was used in the patient’s refractory to macrolide antibiotics. The temperature of five cases returned to normal 1 to 2 days after treatment with levofloxacin, and the imaging of the four cases showed expected improvements. The gastrointestinal symptoms, neurological manifestations, joint symptoms, blood parameters, liver and kidney functions, and exercise conditions of the children were closely monitored. The follow-up time of the patients ranged from one week to five months. No drug-related adverse reactions were observed in patients during treatment or during follow up.Conclusions: The clinical symptoms and imaging significantly improved after treatment with levofloxacin, and no drug-related adverse reactions were observed. Levofloxacin proved to be an effective and safe drug in the treatment of children with macrolide-resistant mycoplasma pneumonia.

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