The report of patients with lung cancer who could receive PDT combined with other modalities like surgery and chemotherapy is relatively rare. Combination of PDT and surgery is useful for multiple lung cancers (MPLC) or minimally invasive procedure to reduce resection line to peripheral site of superficial invasion in advanced lung cancer. Also, PDT combined with chemotherapy for advanced lung cancer with central airway stenosis seems to be usefull for local control and improvement of patient’s QOL.
MPLCs were noted in 22 (34.4%) of 64 patients treated with PDT using Laserphyrin (synchronous:10, and metachronous: 12). Among them, 10 patients (synch:2, meta:8) underwent surgery (lobectomy: 9, pneumonectomy: 1) for peripheral-type lung cancer as their first primary lesion followed by PDT for central type early stage lung cancer. CRs were achieved after PDT in all patients, and all patients were alive. We performed induction PDT to reduce resection line for 28 patents. Among them, histological type revealed squamous cell ca. in 24. Superficial invasion was recognized in trachea: 2, carina: 3, main bronchus or 2nd carina: 22. Reduction surgery could be successfully performed in 23 of 28 patients (82%). PDT combined with chemotherapy was performed for 12 consecutive patients with 13 advanced NSCLC whose stages were IIIA–IV. The median stenosis rates before treatment, 1 week, and 1 month after treatment were 60%, 15%, and 15%, respectively. All patients improved symptoms and QOL after treatment. The mean survival time was 5.9 months, and the overall one-year survival rate was 30.0%.PDT combined with other modalities may be a promising strategy in lung cancer treatment.
We studied a 3-compartment dynamic model of talaporfin sodium pharmacokinetics in silico. Drug distribution might
change after intravenous injection from plasma to interstitial space and then into myocardial cells. We have developed a
new cardiac ablation using photosensitization reaction with laser irradiation shortly after talaporfin sodium injection. We
think that the major cell-killing factor in our cardiac ablation would be an oxidation by singlet oxygen produced in the
interstitial space in myocardium with laser irradiation shortly after the photosensitizer administration. So that the
talaporfin sodium concentration change in time in the interstitial space should be investigated. We constructed the
pharmacokinetics dynamic model composed by 3-compartments, that is, plasma, interstitial space, and cell. We
measured talaporfin sodium fluorescence time change in human skin by our developed fluorescence measurement system
in vivo. Using the measured concentration data in plasma and skin in human, we verified the calculation accuracy of our
in silico model. We compared the simulated transition tendency of talaporfin sodium concentration from interstitial space
to cells in our in silico model with the reported uptake tendency using cultured myocardial cell. We identified the
transition coefficients between plasma, interstitial space, and cell compartment, and metabolization coefficient from
plasma by the fitting with measured data.
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