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The experience of photodynamic therapy (PDT) for malignant brain tumors
EANS Academy. Tanaka K. 09/25/19; 275522; EP03020
Kazuhiro Tanaka
Kazuhiro Tanaka

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Introduction: Photodynamic therapy (PDT) uses the toxicity of singlet oxygen generated by a reaction between a photosensitizer in tumor cells and light with a specific wavelength. Recently, PDT for primary malignant brain tumors was approved in Japan. We retrospectively analyzed the patients treated with PDT in our hospital.
Methods: From August 2017 to February 2019, total 16 patients were performed PDT in our hospital. After the tumor had been resected as extensively as possible, the region of probable tumor invasion in the resection cavity were irradiated superficially with a 664-nm diode laser for 180 sec (27 J/cm2) at a power density of 150 mW/cm. The patients' characteristics, the number of irradiation, adverse event, changes of the MR image, outcome of the patients were analyzed.
Results: In histological examination, glioblastoma (GBM) were 11 cases, anaplastic astrocytoma was 1 case, anaplastic oligodendroglioma were 2 cases, malignant meningioma was 1 case, and malignant lymphoma was 1 case. The mean tumor volume was 44 ml. Gross total resection (GTR), Subtotal resection(STR), and partial resection were performed in 11 patients, 3 patents, and 2 patients, respectively. One patients of anaplastic astrocytoma which was non-enhanced tumor and diagnosed with low grade glioma preoperatively, received PDT in second stage operation. The mean number of irradiated sites was 15 (5~31 sites). In adverse event, venous congestion and brain swelling were observed in one patient. Radiologically, the irradiated site had thin high intensity areas in diffusion-weighted image (DWI), which gradually disappeared for 2 weeks, however, there was no neurological deterioration. This finding seems to be an impairment of microcirculation in irradiated regions. Four patients of GBM had recurrence, one of which recurred in the irradiated site.
Conclusion: PDT was safety and useful for malignant brain tumor. However, brain swelling and venous congestion after PDT should be careful.
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