Document Detail


In vivo fluence rate measurements during Foscan-mediated photodynamic therapy of persistent and recurrent nasopharyngeal carcinomas using a dedicated light applicator.
MedLine Citation:
PMID:  16965135     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective of this study was to evaluate the performance of a dedicated light applicator for light delivery and fluence rate monitoring during Foscan-mediated photodynamic therapy of nasopharyngeal carcinoma in a clinical phase I/II study. We have developed a flexible silicone applicator that can be inserted through the mouth and fixed in the nasopharyngeal cavity. Three isotropic fibers, for measuring of the fluence (rate) during therapy, were located within the nasopharyngeal tumor target area and one was manually positioned to monitor structures at risk in the shielded area. A flexible black silicon patch tailored to the patient's anatomy is attached to the applicator to shield the soft palate and oral cavity from the 652-nm laser light. Fourteen patients were included in the study, resulting in 26 fluence rate measurements in the risk volume (two failures). We observed a systematic reduction in fluence rate during therapy in 20 out of 26 illuminations, which may be related to photodynamic therapy-induced increased blood content, decreased oxygenation, or reduced scattering. Our findings demonstrate that the applicator was easily inserted into the nasopharynx. The average light distribution in the target area was reasonably uniform over the length of the applicator, thus giving an acceptably homogeneous illumination throughout the cavity. Shielding of the risk area was adequate. Large interpatient variations in fluence rate stress the need for in vivo dosimetry. This enables corrections to be made for differences in optical properties and geometry resulting in comparable amounts of light available for Foscan absorption.
Authors:
R L P van Veen; H Nyst; S Rai Indrasari; M Adham Yudharto; D J Robinson; I B Tan; C Meewis; R Peters; S Spaniol; F A Stewart; P C Levendag; H J C M Sterenborg
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Publication Detail:
Type:  Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article; Multicenter Study    
Journal Detail:
Title:  Journal of biomedical optics     Volume:  11     ISSN:  1083-3668     ISO Abbreviation:  J Biomed Opt     Publication Date:    2006 Jul-Aug
Date Detail:
Created Date:  2006-09-12     Completed Date:  2007-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9605853     Medline TA:  J Biomed Opt     Country:  United States    
Other Details:
Languages:  eng     Pagination:  041107     Citation Subset:  IM    
Affiliation:
Erasmus Medical Center, Center of Optical Diagnosis and Therapy, Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Equipment Design
Equipment Failure Analysis
Female
Humans
Indonesia
Light
Lighting / instrumentation*
Male
Mesoporphyrins / therapeutic use*
Nasopharyngeal Neoplasms / drug therapy*
Neoplasm Recurrence, Local / drug therapy*
Photochemotherapy / instrumentation*,  methods
Photosensitizing Agents / therapeutic use
Pilot Projects
Radiation Dosage
Radiometry
Treatment Outcome
Chemical
Reg. No./Substance:
0/Mesoporphyrins; 0/Photosensitizing Agents; 0/temoporfin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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