Safety of two sequential whole bladder photodynamic therapy (WBPDT) treatments in the management of resistant bladder cancer

Unyime O. Nseyo M.D.; C. Ryan Barnes; Jessicca I. Martin; Donald L. Lamm; Cindy Carpenter

doi:10.1117/12.482788

12 September 2003 Safety of two sequential whole bladder photodynamic therapy (WBPDT) treatments in the management of resistant bladder cancer

Unyime O. Nseyo M.D., C. Ryan Barnes, Jessicca I. Martin, Donald L. Lamm, Cindy Carpenter

Author Affiliations +

Proceedings Volume 4949, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems XIII; (2003) https://doi.org/10.1117/12.482788
Event: Biomedical Optics, 2003, San Jose, CA, United States

Abstract

While 55 - 60% of newly diagnosed bladder cancers are superficial, a significant number recur as higher grade and/or stage tumors. WBPDT has been used to treat some of these recurrent superficial tumors, although its use has been associated with dose-dependent side effects. Preclinical investigation of three sequential WBPDT treatments using lower PDT dose in normal canine bladder resulted in a lack of permanent bladder contracture. Lower dose single PDT treatment has shown less durable tumor response; however, sequential WBPDT treatments with lower dose may result in durable tumor response. Five patients (4 male, 1 female), average age 65.6 (62-72 years), with recurrent or resistant superficial TCC of the bladder received two WBPDT treatments. First treatment occurred at baseline and the second treatment at 6 months. Photofrin (1.5 mg/kg) was given intravenously 48 hours prior to each cystoscopic treatment with laser light (630 nm, Coherent Lambda-Plus laser). Total light treatment doses were 1500 - 2500 Joules at baseline and 1000- 1500 Joules at 6 months. Moderate irritative bladder symptoms occurred in all patients the first week post PDT. No cases of bladder contracture have occurred. 4 of 5 patients showed no evidence of disease during the follow-up period (12 - 18 months post second treatment). One patient had a recurrence at 18 months post second treatment. Mean disease-free interval is 16.2 months. The safety of two sequential WBPDT treatments is suggested by this preliminary data. Assessment of efficacy will be possible wit a large number of patients and a longer follow-up period.

Citation Download Citation

Unyime O. Nseyo M.D., C. Ryan Barnes, Jessicca I. Martin, Donald L. Lamm, and Cindy Carpenter "Safety of two sequential whole bladder photodynamic therapy (WBPDT) treatments in the management of resistant bladder cancer", Proc. SPIE 4949, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems XIII, (12 September 2003); https://doi.org/10.1117/12.482788

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