J Breast Cancer.  2014 Jun;17(2):161-166.

A Pilot Randomized Clinical Study of the Additive Treatment Effect of Photodynamic Therapy in Breast Cancer Patients with Chest Wall Recurrence

Affiliations
  • 13rd Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin, China. jzhangtjmu@gmail.com
  • 2Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China.
  • 3Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.

Abstract

PURPOSE
This study investigated the additive effect of photodynamic therapy (PDT) plus traditional radiotherapy (RT) for patients with breast cancer and chest wall recurrence.
METHODS
A total of 40 patients with recurrent breast cancer were prospectively randomized to receive RT alone (group A, n=20) or PDT and RT in combination (group B, n=20). Traditional RT at a dose of 50 Gy was delivered in 25 fractions with or without exposure to 5-aminolevulinic acid and red light as PDT.
RESULTS
The response rates were not statistically different between the groups, but more patients achieved a complete response (CR) in group B (50%) than in group A (20%). The median time to CR in group B was significantly shorter than that in group A (109.6 days vs. 175.2 days, p=0.001). Adverse event profiles were not different between the groups.
CONCLUSION
An additive antitumor effect is demonstrated with additional PDT to RT. This combination therapy might reduce the duration of exposure to RT, but further investigation is warranted.

Keyword

Breast neoplasms; Photochemotherapy; Recurrence; Thoracic wal

MeSH Terms

Breast Neoplasms*
Humans
Photochemotherapy*
Prospective Studies
Radiotherapy
Recurrence*
Thoracic Wall*

Figure

  • Figure 1 Study schema.

  • Figure 2 Comparisons of response rates between groups according to the size of lesion. PDT=photodynamic therapy; RT=traditional radiotherapy.


Reference

1. Lee MC, Jagsi R. Postmastectomy radiation therapy: indications and controversies. Surg Clin North Am. 2007; 87:511–526.
Article
2. Danish Breast Cancer Cooperative Group. Nielsen HM, Overgaard M, Grau C, Jensen AR, Overgaard J. Study of failure pattern among high-risk breast cancer patients with or without postmastectomy radiotherapy in addition to adjuvant systemic therapy: long-term results from the Danish Breast Cancer Cooperative Group DBCG 82 b and c randomized studies. J Clin Oncol. 2006; 24:2268–2275.
Article
3. Ragaz J, Olivotto IA, Spinelli JJ, Phillips N, Jackson SM, Wilson KS, et al. Locoregional radiation therapy in patients with high-risk breast cancer receiving adjuvant chemotherapy: 20-year results of the British Columbia randomized trial. J Natl Cancer Inst. 2005; 97:116–126.
Article
4. van der Pol CC, van Geel AN, Menke-Pluymers MB, Schmitz PI, Lans TE. Prognostic factors in 77 curative chest wall resections for isolated breast cancer recurrence. Ann Surg Oncol. 2009; 16:3414–3421.
Article
5. Chagpar A, Meric-Bernstam F, Hunt KK, Ross MI, Cristofanilli M, Singletary SE, et al. Chest wall recurrence after mastectomy does not always portend a dismal outcome. Ann Surg Oncol. 2003; 10:628–634.
Article
6. Koppert LB, van Geel AN, Lans TE, van der Pol C, van Coevorden F, Wouters MW. Sternal resection for sarcoma, recurrent breast cancer, and radiation-induced necrosis. Ann Thorac Surg. 2010; 90:1102–1108.e2.
Article
7. Leonard R, Hardy J, van Tienhoven G, Houston S, Simmonds P, David M, et al. Randomized, double-blind, placebo-controlled, multicenter trial of 6% miltefosine solution, a topical chemotherapy in cutaneous metastases from breast cancer. J Clin Oncol. 2001; 19:4150–4159.
Article
8. Daniell MD, Hill JS. A history of photodynamic therapy. Aust N Z J Surg. 1991; 61:340–348.
Article
9. Ackroyd R, Kelty C, Brown N, Reed M. The history of photodetection and photodynamic therapy. Photochem Photobiol. 2001; 74:656–669.
Article
10. Lipson RL, Gray MJ, Baldes EJ. Haematoporphyria derivative for detection and management of cancer. In : Proceedings of the 9th International Cancer Congress; 1966. p. 393.
11. Gray MJ, Lipson R, Maeck JV, Parker L, Romeyn D. Use of hematoporphyrin derivative in detection and management of cervical cancer. Am J Obstet Gynecol. 1967; 99:766–771.
Article
12. Rosenthal DI, Glatstein E. Clinical applications of photodynamic therapy. Ann Med. 1994; 26:405–409.
Article
13. Sutedja TG, Postmus PE. Photodynamic therapy in lung cancer: a review. J Photochem Photobiol B. 1996; 36:199–204.
Article
14. Xue LY, Chiu SM, Oleinick NL. Photochemical destruction of the Bcl-2 oncoprotein during photodynamic therapy with the phthalocyanine photosensitizer Pc 4. Oncogene. 2001; 20:3420–3427.
Article
15. Saczko J, Chwiłkowska A, Kulbacka J, Berdowska I, Zieliński B, Drag-Zalesińska M, et al. Photooxidative action in cancer and normal cells induced by the use of photofrin in photodynamic therapy. Folia Biol (Praha). 2008; 54:24–29.
16. Moan J, Peng Q. An outline of the hundred-year history of PDT. Anticancer Res. 2003; 23(5A):3591–3600.
17. Ramakrishnan N, Clay ME, Friedman LR, Antunez AR, Oleinick NL. Post-treatment interactions of photodynamic and radiation-induced cytotoxic lesions. Photochem Photobiol. 1990; 52:555–559.
Article
18. Ben-Hur E, Kol R, Marko R, Riklis E, Rosenthal I. Combined action of phthalocyanine photosensitization and gamma-radiation on mammalian cells. Int J Radiat Biol. 1988; 54:21–30.
Article
19. Prinsze C, Penning LC, Dubbelman TM, VanSteveninck J. Interaction of photodynamic treatment and either hyperthermia or ionizing radiation and of ionizing radiation and hyperthermia with respect to cell killing of L929 fibroblasts, Chinese hamster ovary cells, and T24 human bladder carcinoma cells. Cancer Res. 1992; 52:117–120.
20. Kavarnos G, Nath R, Bongiorni P. Visible-light and X irradiations of Chinese hamster lung cells treated with hematoporphyrin derivative. Radiat Res. 1994; 137:196–201.
Article
21. Wang J, Hyun W, Lamborn K, Deen DF. Measurement of radiation-induced damage in human glioma cells with flow cytometry. Cancer Res. 1996; 56:154–157.
22. Pass HI. Photodynamic therapy in oncology: mechanisms and clinical use. J Natl Cancer Inst. 1993; 85:443–456.
Article
23. Fingar VH, Kik PK, Haydon PS, Cerrito PB, Tseng M, Abang E, et al. Analysis of acute vascular damage after photodynamic therapy using benzoporphyrin derivative (BPD). Br J Cancer. 1999; 79:1702–1708.
Article
24. Dolmans DE, Kadambi A, Hill JS, Waters CA, Robinson BC, Walker JP, et al. Vascular accumulation of a novel photosensitizer, MV6401, causes selective thrombosis in tumor vessels after photodynamic therapy. Cancer Res. 2002; 62:2151–2156.
25. Busch TM, Wileyto EP, Emanuele MJ, Del Piero F, Marconato L, Glatstein E, et al. Photodynamic therapy creates fluence rate-dependent gradients in the intratumoral spatial distribution of oxygen. Cancer Res. 2002; 62:7273–7279.
26. Henderson BW, Dougherty TJ. How does photodynamic therapy work. Photochem Photobiol. 1992; 55:145–157.
Article
27. Shumaker BP, Hetzel FW. Clinical laser photodynamic therapy in the treatment of bladder carcinoma. Photochem Photobiol. 1987; 46:899–901.
Article
28. de Vree WJ, Essers MC, de Bruijn HS, Star WM, Koster JF, Sluiter W. Evidence for an important role of neutrophils in the efficacy of photodynamic therapy in vivo. Cancer Res. 1996; 56:2908–2911.
29. Korbelik M, Krosl G, Krosl J, Dougherty GJ. The role of host lymphoid populations in the response of mouse EMT6 tumor to photodynamic therapy. Cancer Res. 1996; 56:5647–5652.
30. Stukavec J, Horak L, Duchac V, Jirasek T, Rakusan J, Karaskova M, et al. Comparison of photodynamic therapy with phthalocyanine and photofrin in human colorectal carcinoma. Neoplasma. 2008; 55:127–129.
Full Text Links
  • JBC
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr