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August 2001. Review Article. . To the updating
Photodynamic therapy is a form of cancer treatment and has a potentially important role either as a primary or adijuvant mode of treatment of tumours of the gastrointestinal tract.
PDT shows considerable promise as a primary treatment modality for localized superficial tumours and is a potentially important form of adjuvant treatment for cancers of the GI tract.
The major side effect of PDT is cutaneous photosensitization. The major limitation of PDT is depth of tumour kill.
The use of photosensitive drugs has diagnostic applicability because photoreactive agents are also fluorescent, permitting tumour localization with a suitable imaging system.
The clinical applications of PDT are just emerging in relation to the technologic advances
( 1 ).
PDT has found applicability in the treatment of malignant and benign tumours involving the skin, GI tract, retroperitoneum, genital and urinary systems, chest, central nervous system and eye.
Hendren and collegues publish an initial report of their phase II trial designed to evaluate the effectiveness of surgical debulking and PDT in carcinomatosis and sarcomatosis. Photodynamic therapy combines photosensitizer drug, oxygen and laser light to kill tumour cells on surface. Photofrin PDT for carcinomatosis has been successfully administered to 42 patients, with acceptable toxicity. The median follow up of 21 months exceeds the expectations; however the relative contribution of surgical resection versus PDT is unknown. Deficiencies in photosensitizer delivery, tissue oxigenation, or laser light distribution leading to recurrences may be addressed through the future use of new photosensitizers ( 4 ).
1) J Webber, M Herman, D Kessel, D Fromm. Current concepts in gastrointestinal photodynamic therapy. Annals of Surgery, vol 230; n1 12-23, 1999.
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