Retrospective study of photodynamic therapy vs photodynamic therapy combined with chemotherapy and chemotherapy alone on advanced esophageal cancer.

OBJECTIVE: To compare the short-term curative effect of photodynamic therapy (PDT), PDT combined with chemotherapy and chemotherapy alone on the advanced esophageal cancer patients. METHODS: Retrospective analysis of 90 patients of esophageal cancer underwent PDT, PDT combined with chemotherapy and chemotherapy alone from 2004 to 2007 (stages III-IV), including 27 cases received PDT alone, 33 cases received PDT combined with chemotherapy and 30 cases chemotherapy alone. The enrolled patients were treated with intravenous administration of Photofrin as the photosensitizer at a dose of 2mg/kg. 630 nm laser irradiation was performed through optical fiber that passed through the biopsy channel of a flexible endoscope after 48 h. Two days later, the necrotic tissue was removed, and the primary sites and other newly identified lesions were subjected to a second irradiation and then the residual necrotic tissue was removed according to the patients' condition. Electronic endoscopy was performed to observe the effectiveness on tumor after 1 month. In PDT combined with chemotherapy group, chemotherapy regimen was 5-FU and DDP, administered 4 cycles after PDT and chemotherapy alone group only chemotherapy regimen 5-FU and DDP for four cycles. All the 90 patients were followed up for 2 years. RESULTS: Symptomatic palliation rate of the PDT alone group, the complex treatment group and chemotherapy alone group was 85.2%, 93.9% and 60.0%, respectively, and effective rate under endoscopy was 85.2%, 90.9% and 63.3%, respectively, there is no statistically significant difference; the survival rate of 2 years was 29.6%, 54.5% and 16.7%, respectively, and medium survival time is longer (III stages 13 m, 22 m, 10 m; IV stages 7 m, 5m, 4m), there is statistically significant difference (p=0.046). CONCLUSION: PDT combined with chemotherapy for the advanced esophageal cancer is superior to PDT alone and chemotherapy alone.

[Topical dimethyl sulfoxide and intralesional hyaluronidase administration for vinorelbine extravasation-induced rat skin injury].

OBJECTIVE: To evaluate the effects of topical DMSO and intralesional hyaluronidase administration, used alone or in combination, on skin injury due to vinorelbine extravasation in rats. METHODS: Skin injury due to vinorelbine extravasation was induced in the lower extremities of 30 SD rats, which were treated subsequently with topical DMSO, intralesional hyaluronidase, their combination, topical saline, and intralesional saline, with the rats without any treatment as the control. The wound area on 1, 4, 8, 12, 18, 24, 30 days and the time of healing were observed and compared. RESULTS: The wound area on 1, 4, 8, 12, 18, and 24 days were significantly smaller in topical DMSO group than in topical saline and control groups (P<0.05), and so in intralesional hyaluronidase group than in intralesional saline and control groups (P<0.05), but there was no significant difference between single agent (hyaluronidase and DMSO) treatment group and the combined treatment group. The healing time was significantly shorter in topical DMSO and intralesional hyaluronidase groups than in topical and intralesional saline groups and control group ( 24.9-/+3.2 and 21.9-/+3.0 days vs 29.8-/+2.6, 28.6-/+4.1 and 30.6-/+3.0 days, P<0.01), but comparable between the two single agent groups and combined treatment group (23.3-/+3.8 days). CONCLUSION: Intralesional hyaluronidase and topical DMSO application are effective therapies for skin damage due to vinorelbine extravasation, and their combination does not improve the therapeutic effect.

Clinical study of Photofrin photodynamic therapy for the treatment of relapse nasopharyngeal carcinoma.

OBJECTIVES: To evaluate the clinical response and adverse effects of Photofrin photodynamic therapy (PDT) in patients with relapse nasal pharyngeal cancer. METHODS: Thirty patients with relapse nasal pharyngeal cancer were randomly divided into PDT group and chemotherapy group. In PDT group, patients received intravenous administration of Photofrin (2mg/kg b.w.) and 48h later light (200-300J/cm) was delivered by a 630nm diode laser through a cylinder diffuser under endoscopic assistance. Two days after PDT the necrotic tissues were removed and newly identified sites were subject to another round of light irradiation. In chemotherapy group, the routine cisplatin and 5-fluorouracil (DDP/5-FU) remedy was used. Endoscopic and radiological examinations were performed during 6 months follow-up. The Karnofsy Score was used to evaluate the quality of life. RESULTS: The local response and nasal cavity obstruction remission rate in PDT group were better than that in chemotherapy group. The Karnofsy Score was also improved in PDT group. CONCLUSION: This pilot study suggests that Photofrin PDT is effective and safe in treatment of advanced nasal pharyngeal cancer and management of nasal obstruction.

[Killing effect of Photofrin-Herceptin immunoconjugate on tumor cell lines in vitro].

OBJECTIVE: To study the specific killing effect of the Photofrin-Herceptin immunoconjugate on the tumor cells expressing HER-2. METHODS: Photofrin (porfimer sodium) was covalently coupled to Herceptin (trastuzumab) via [1-ethyl-3-(3-dimethyl-aminopropyl)carbodiimide hydrochloride](EDCI) , and the killing effect of this conjugate was evaluated by means of MTT assay on SK-BR-3, MCF-7 and A549 cell lines expressing HER-2 at different levels. RESULTS: The conjugate had weaker immunoactivity than Herceptin, but possessed stronger killing effect on the cell lines expressing HER-2 than Photofrin, Herceptin, as well as the mixture of Photofrin and Herceptin (P<0.05). In the cell lines negative for HER-2 expression, the killing effect of the conjugate was similar to that of Photofrin, Herceptin, and their mixture. CONCLUSION: Photofrin-Herceptin immunoconjugate can specifically kill HER-positive cells in vitro.

[Investigation of short-term therapy results for radiofrequency ablation by positron emission tomography].

OBJECTIVE: To explore the possibility of evaluating the short-term therapeulic effect of radiofrequency ablation (RFA) in cancer treatment by positron emission tomography. METHODS: The radioactivity intensity of the tumor was detected by PET before and after RFA. RESULTS: Radioactivity blank was observed in all 33 cases with 54 lesions, indicating the elimination of the tumor was destroyed. CONCLUSION: PET is of great significance in evaluating the short-term effect of RFA.