photodynamic diagnosis therapy - gfmer.ch · • photodynamic therapy (pdt) can be used efficiently...
TRANSCRIPT
![Page 1: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/1.jpg)
PHOTODYNAMIC DIAGNOSIS &
THERAPY
PHOTODYNAMIC DIAGNOSIS &
THERAPY
Attila L. Major, MD, PhD, PD
![Page 2: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/2.jpg)
Presentation PlanPresentation Plan
• Introduction photomedicine• Photodetection (PDD)• Photodynamic Therapy (PDT)• Conclusion / Perspective
![Page 3: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/3.jpg)
Photodynamic Principle Photodynamic Principle
• Use of a photo-enhancing or photo-sensitizing chemical to aid in the diagnosis or treatment of a target cell
• Use of a photo-enhancing or photo-sensitizing chemical to aid in the diagnosis or treatment of a target cell
![Page 4: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/4.jpg)
HistoricalHistoricalHistorical19761976 J. F. KELLY + M. E. SNELL J. F. KELLY + M. E. SNELL -- FirstFirst clinicalclinical PDT PDT ofof aa
bladderbladder carcinomacarcinoma withwith HPD. (J. HPD. (J. UrolUrol., 115, 150, 1976).., 115, 150, 1976).
19781978 T. J. DOUGHERTY et al.T. J. DOUGHERTY et al.-- ClinicalClinical assessmentassessment ofof PDTPDT(Cancer (Cancer ResRes., 38, 2628, 1978).., 38, 2628, 1978).
! LASERS + OPTICAL FIBERS !! LASERS + OPTICAL FIBERS !
19931993 FirstFirst approvalapproval (by (by thethe canadiancanadian healthhealth agencyagency) ) ofof PDTPDTwithwith PhotofrinPhotofrin®® for for thethe prophylacticprophylactic treatmenttreatment ofofbladderbladder cancer.cancer.
![Page 5: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/5.jpg)
Photophysical ProcessesPhotophysicalPhotophysical ProcessesProcesses
Fluorescence Fluorescence detectiondetection PhotodynamicPhotodynamic TherapyTherapy
S0
S1
S2
T1
AbsorptionAbsorption
FluorescenceFluorescence630 nm630 nm
700 nm700 nm630 nm630 nm
400 nm400 nm
Ene
rgy
ISCICIC
= 1ns= 1nsττ
PhosphorescencePhosphorescence
= 10µsτ = 250 nstd = 45 nm∆
Singlet Oxygenproduction
OO3322
**22
11OO
collision energytransfer
SpectroscopySpectroscopy
![Page 6: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/6.jpg)
![Page 7: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/7.jpg)
PhotosensitizersPhotosensitizers
• Porphyrins– Photofrin (PF) – "Aminolevulinic acid (ALA)", Protoporphyrin IX
(PpIX)• Chlorins
– m-Tetrahydroxyphenyl chlorin (mTHPC): Temoporfin (Foscan, Foslip)
– Benzoporphyrin derivative mono-acid (BPD): Verteporfin (Visudyne)
– Tin ethyl etiopurpurin (SnET2)• Phtalocyanines
![Page 8: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/8.jpg)
Photofrin ApprovalPhotofrin Approval
• Superficial bladder cancer (Canada 1993)
• Early and late oesophageal and lung ca (Netherlands 1994)
• Advanced oesophageal ca (USA 1995)
• Early ca of stomach, oesophagus, lung, cervix and cervical dysplasia (Japan 1994)
![Page 9: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/9.jpg)
Approvals of second generation photosensitizers
Approvals of second generation photosensitizers
• Temoporfin (Foscan, Biolitec) : PDT head and neck cancer (USA 2001)
• Meth-aminolaevulinate (Metvix, Galderma): PDT actinic keratosis, basal cell carcinoma (EU and Australia 2003)
• Hex-aminolaevulinate: PDD bladder cancer (Sweden 2004, EU 2005)
• Verteporfin (Visudyne, QLT, Novartis): macular degeneration of the retina (USA and EU 2002)
![Page 10: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/10.jpg)
PHOTODETECTIONPHOTODETECTION
![Page 11: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/11.jpg)
ProblematicFLUORESCENCE SPECTROSCOPY OF EXOGENOUS, EXOGENOUSLY-INDUCED AND ENDOGENOUS FLUOROPHORES FOR THE PHOTODETECTION AND PHOTODYNAMIC THERAPY OF CANCER. Early cancers are
easier to treatAdvanced cancerDifficult to treat
Early cancer are difficult to detect
MetastasesLocalized Radiography, endoscopy, MRI
ContrastEarly lesion /
normal surroundingMatthieu Zellweger, Février 2000
![Page 12: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/12.jpg)
Principle of fluorescenceFLUORESCENCE SPECTROSCOPY OF EXOGENOUS, EXOGENOUSLY-INDUCED AND ENDOGENOUS FLUOROPHORES FOR THE PHOTODETECTION AND PHOTODYNAMIC THERAPY OF CANCER.
Fluorescent molecule
∆E > 0 ∆E < 0
ExcitationPhoton
Fluorescence photon
Matthieu Zellweger, Février 2000
![Page 13: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/13.jpg)
Haem BiosynthesisHaem Biosynthesis
5-ALA synthase Uptake of exogenous 5-ALA
PBG Deaminase
Cytoplasma
Lower rate in Lower rate in tumourtumour cellscells
Higher rate in Higher rate in tumourtumour cellscells
CoproporphyrinogenCoproporphyrinogen IIIIII
UroporphyrinogenUroporphyrinogen IIIIII
PorphyrinogenPorphyrinogen55--ALAALA55--ALAALA
GyclineGycline++
succinylsuccinyl CoACoA
haemhaem
ProtoporphyrinProtoporphyrin IXIX
ProtoporphyrinogenProtoporphyrinogen IXIX
Feedback controlFeedback control
MitochondriaMitochondria
FeFe2+2+Ferrochelatase
![Page 14: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/14.jpg)
Haem BiosynthesisHaem Biosynthesis
5-ALA synthase Uptake of exogenous 5-ALA
PBG Deaminase
Cytoplasma
Lower rate in Lower rate in tumourtumour cellscells
CoproporphyrinogenCoproporphyrinogen IIIIII
UroporphyrinogenUroporphyrinogen IIIIII
PorphyrinogenPorphyrinogen55--ALAALA55--ALAALA
GyclineGycline++
succinylsuccinyl CoACoA
haemhaem
ProtoporphyrinProtoporphyrin IXIX
ProtoporphyrinogenProtoporphyrinogen IXIX
Feedback controlFeedback control
MitochondriaMitochondria
FeFe2+2+Ferrochelatase
Higher rate in Higher rate in tumourtumour cellscells
![Page 15: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/15.jpg)
Combined Diagnosis System
• White Light• ALA-Mode• Autofluorescence-Mode
• Rigid Telescopes• Fiberscopes• OP - Microscopes
![Page 16: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/16.jpg)
P HOTODETECTION
![Page 17: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/17.jpg)
Clinical Data
M. M. KriegmairKriegmair, ,
Ludwig Ludwig MaximilliansMaximillians--UniversityUniversity MunichMunich
![Page 18: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/18.jpg)
Neurosurgery
Special FluorescenceMicroscopeCooperation w/ Carl Zeiss
Early Tumor Detectionwith Marker Substance
High grade Glioma
Stummer, Stummer, ReulenReulenMunichMunich--GroGroßßhadernhadern
![Page 19: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/19.jpg)
Detection of Early Stage Bronchial Carcinomas (AF)
K. K. HHääuußßingeringer, F. , F. StanzelStanzel
AskleipiosAskleipios MunichMunich-- GautingGauting
![Page 20: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/20.jpg)
PDD in GynaecologyPDD in Gynaecology
• Laparoscopic view of ovarian cancer after ip ALA-application
A
B
A. MajorA. Major
GenevaGeneva University HospitalUniversity Hospital
![Page 21: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/21.jpg)
Light micrographs (A) andfluorescence (B) of a peritoneal
nodule (size < 0.5 mm) 6 hrafter ip ALA administration.
Magnification (C) of theperitoneal serosa (boxed area in
B) showing a thin layer oftumor matching with the
fluorescence
Light micrographs (A) andfluorescence (B) of a peritoneal
nodule (size < 0.5 mm) 6 hrafter ip ALA administration.
Magnification (C) of theperitoneal serosa (boxed area in
B) showing a thin layer oftumor matching with the
fluorescence
Major A. et al Gynecol Oncol 1996, 66 : 122-32.
![Page 22: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/22.jpg)
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
0-1st 0-2nd 0-3th 0-4th 0-5th
Other genital organs(vulva and vagina)
Cervix uteri
Corpus uteriBreast
Ovary
5-Year cumulative lethality of gynecologic malignancies in Geneva
![Page 23: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/23.jpg)
Figure 1
Common sites of ovarian cancer metastases. Ovarian cancer spreads fast to the whole abdominal cavity by exfoliation
(stage III)
(stage IV)
Parenchymal
(stage III)
(stage Ic or IIc)
(stage Ib)
(stage IIa)
(stage IIb)
(stage IIa)
(stage IIIc)
(stage III)
(stage IV)
![Page 24: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/24.jpg)
Epithelial Ovarian CancerEpithelial Ovarian CancerEpithelial Ovarian Cancer
• Fourth most frequent cause of “cancer-related” death
• 65% diagnosed with stage III-IV disease
• 80% chemo-sensitive (initial response)• 5 year survival rate: 15-20%• 50% of “cured” patients (negative second
look laparotomy) will recur
• Fourth most frequent cause of “cancer-related” death
• 65% diagnosed with stage III-IV disease
• 80% chemo-sensitive (initial response)• 5 year survival rate: 15-20%• 50% of “cured” patients (negative second
look laparotomy) will recur
![Page 25: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/25.jpg)
Potential of In Vivo FluorescencePotential of In Vivo Fluorescence
• Staging laparotomy– 30% upstaged (Young RC, JAMA, 1983;
Zanetta G, Ann Oncol, 1998)• Second Look
– 50% recurrence of negative second-look after combination chemotherapy (DiSaia PJ, Mosby-Year Book, 1997)
![Page 26: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/26.jpg)
Results of restaging laparotomies in women withapparent early stage ovarian carcinoma
Results of restaging laparotomies in women withapparent early stage ovarian carcinoma
Authors (year) Number ofpatients
FIGO stage atinitial surgery
% upstaged
Bagley 1973 5 I-II 60%
Young 1983 100 IA-IIB 31%
Helewa 1986 25 I 20-25%
Buchsbaum 1989 140 I-II 22,4%
Archer 1991 24 I-II 20,8%
Soper 1992 30 I-II 30%
Stier 1998 45 IA-IIB 16%
Leblanc 2000 28 I 21%
![Page 27: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/27.jpg)
Survival by outcome of second lookSurvival by outcome of second look
neg second look
microsc pos
macrosc pos
![Page 28: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/28.jpg)
Ovarian cancer PDD secondOvarian cancer PDD second--look look feasabilityfeasability StudyStudyStage III-IV ovarian + 6-8 cycles taxoid platinum chemotherapy
Clinical complete response
Second-look operation with white light and PDD. Retrospective DataNo second-look
Neg. second-look operationwith white and PDD.
Pos. second-look operationwith white light or PDD
Lesions < 1/2 cm via white or PDD or
microscopic disease
Macroscopic lesions > 1/2cm via
white or PDD
Second-linechemotherapy
Second linechemotherapy.
Survival data. Survival data. Survival data Retrospectivesurvival data.
![Page 29: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/29.jpg)
CONCLUSIONSCONCLUSIONS
• Photodetection of ovarian cancer peritoneal implants, not visible by other methods, has been shown to be efficient and feasible in patients
• Survival advantage has to be demonstrated in clinical trials (second look and staging of first stage ovarian cancer)
![Page 30: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/30.jpg)
PHOTODYNAMIC THERAPY PHOTODYNAMIC THERAPY
![Page 31: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/31.jpg)
![Page 32: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/32.jpg)
PHOTODYNAMIC THERAPYPHOTODYNAMIC THERAPY
Dye(PS)
Photons
DYE TOXICITYTOXICITY02
ACTIVATEDACTIVATED
![Page 33: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/33.jpg)
Methaminolaevulinate (MAL) PDT in Aktinic Keratosis
TrondTrond WarloeWarloe
Radium Hospital OsloRadium Hospital Oslo
![Page 34: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/34.jpg)
MAL-PDT in Basal Cell Carcinoma
TrondTrond WarloeWarloe
Radium Hospital OsloRadium Hospital Oslo
![Page 35: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/35.jpg)
MAL-PDT in Basal Cell Carcinoma
TrondTrond WarloeWarloe
Radium Hospital OsloRadium Hospital Oslo
![Page 36: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/36.jpg)
A. MajorA. Major
GenevaGeneva University HospitalUniversity Hospital
![Page 37: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/37.jpg)
A. MajorA. Major
GenevaGeneva University HospitalUniversity Hospital
![Page 38: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/38.jpg)
A. MajorA. Major
GenevaGeneva University HospitalUniversity Hospital
![Page 39: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/39.jpg)
CONCLUSIONSCONCLUSIONS
• Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy
• PDT heals with better cosmetic results compared to other treatments (surgery, cryotherapy)
• PDT has no long term side effects and has no limitations to repeat it
![Page 40: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/40.jpg)
![Page 41: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/41.jpg)
![Page 42: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/42.jpg)
![Page 43: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/43.jpg)
Attila L. Major
Pierre-Marie TebeuBianca Mottironi
Magali ZeisserAnis Fekih
Frank Ludicke
Youri Popowski
FONDATION POURRECHERCHESMÉDICALES
FONDATION POURRECHERCHESMÉDICALES
Hubert van den Bergh
Georges Wagnières
Norbert LangeJean-Pierre Ballini
![Page 44: PHOTODYNAMIC DIAGNOSIS THERAPY - gfmer.ch · • Photodynamic therapy (PDT) can be used efficiently in patient who were already treated with surgery, radiotherapy and chemotherapy](https://reader033.vdocuments.us/reader033/viewer/2022053006/5f09ee2d7e708231d429303e/html5/thumbnails/44.jpg)
Autofluorescence (ENT)
Carcinoma of the left vocal cord,precancerous lesion right vocal cord
(bacterial growth)
Early Tumor Detectionwithout Marker Substance
K. Malzahn, C. Arens, H. GlanzK. Malzahn, C. Arens, H. Glanz
JustusJustus--LiebigLiebig--UniversityUniversity GiessenGiessen