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10.1245/ASO.2005.09.005
Annals of Surgical Oncology 12:808-816 (2005)
© 2005 Society of Surgical Oncology
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Original Article

Photodynamic Therapy With 5,10,15,20-Tetrakis(m-Hydroxyphenyl) Bacteriochlorin for Colorectal Liver Metastases Is Safe and Feasible: Results From a Phase I Study

Frederieke H. van Duijnhoven, MD, PhD1, Jeroen P. Rovers, MD, PhD1, Kerstin Engelmann, MD2, Zdenko Krajina, MD, PhD3, Shaun F. Purkiss, MS, FRCS4, Frans A. N. Zoetmulder, MD, PhD5, Thomas J. Vogl, MD, PhD2 and Onno T. Terpstra, MD, PhD, FRCS1

1 Department of Surgery, K6-R, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands
2 Diagnostische und Interventionelle Radiologie, Zentrum der Radiologie, Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany
3 Department for Oncology and Radiotherapy, Clinical Hospital Osijek, Osijek, Croatia
4 Department of Surgery, The Royal London Hospital, London, United Kingdom
5 Department of Medical Oncology, The Netherlands Cancer Institute/Slotervaart Hospital, Amsterdam, The Netherlands

Correspondence: Address correspondence and reprint requests to: Onno T. Terpstra, MD, PhD, FRCS; E-mail: o.t.terpstra{at}lumc.nl.

Background: The prognosis for patients with liver metastases from colorectal carcinoma is limited because of the low number of patients who are eligible for curative hepatic resection. In this phase I study, 31 liver metastases in 24 patients with nonresectable metastases from colorectal carcinoma were treated with photodynamic therapy (PDT).

Methods: The photosensitizer 5,10,15,20-tetrakis(m-hydroxyphenyl)bacteriochlorin (mTHPBC) was intravenously administered in a dose of .6 mg/kg (n = 12) or .3 mg/kg (n = 12). After 120 hours (n = 18) or 48 hours (n = 6), tumors were illuminated for 300 to 600 seconds through percutaneously inserted optical fibers with a light dose of 60 J/cm of diffuser (740 nm).

Results: Tumor necrosis at 1 month after PDT was achieved in all treated lesions. Laser treatment was associated with mild pain (n = 8) and transient subclinical hepatotoxicity (n = 21). In one patient, PDT damage to the pancreas was inflicted, and in another patient, PDT damage of the skin occurred, but no serious clinical complications from PDT were reported. Administration of .6 mg/kg of mTHPBC led to transient phlebitis in 10 patients, and 3 patients experienced mild skin phototoxicity after excess light exposure.

Conclusions: Colorectal liver metastases that are ineligible for resection can be safely and effectively treated with interstitial mTHPBC-based PDT.

Key Words: Photodynamic therapy • Liver metastases • Colorectal cancer • Phase I






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