Artikel
Intraoperative photodynamic diagnosis of human glioma using the novel photosensitizer Talaporfin
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Veröffentlicht: | 8. Mai 2006 |
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Gliederung
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Objective: Photodynamic diagnosis (PDD) has already been established for the intraoperative diagnosis of malignant brain tumor. A new photosensitizer, Talaporfin (Laserphyrin_), which is characterized by: a greater affinity for the tumor and less toxicity than previous photosensitizers, being water-soluble, and is easily washed-out from the body within 24 hrs, was reported to be effective for both PDD and photodynamic therapy (PDT) of cancer. We employed Talaporfin for the intraoperative PDD of glioma patients, and this yielded some important facts.
Methods: Eleven consecutive patients with glioblastoma (8 primary and 3 recurrent, aged 24-70 years) received intravenous doses of Talaporfin (40 mg/m2) 4, 6 and 24 hours prior to craniotomy. Intraoperatively, tumor fluorescence was visualized using a modified operating microscope. Fluorescence-guided resection of tumor tissue was performed.
Results: A celar fluorescence signal was demonstrated in the tumor bulk and peritumoral zone, regardless of the lapse of time from administration. However, up to 6 hours after administration, the cortical vessels also showed the fluorescence. The satisfactory resection of contrast-enhancing tumor was confirmed by MRI in all cases, and the intensity of the intraoperative fluorescence signal was correlated with the histopathological findings.
Conclusions: The clinical experience in this study indicates the usefulness of Talaporfin-induced tumor fluorescence for guiding tumor resection. We will discuss the problems and advantages of this strategy.