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Published on: October 27, 2014
Photodynamic therapy using talaporfin sodium for non-totally resectable malignant glioma
Shinjiro Fukami1, Jiro Akimoto2, Kenta Nagai1
1Department of Neurosurgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-023, Japan.
Background:
For malignant glioma, intraoperative photodynamic therapy (PDT) using talaporfin sodium is a powerful tool for local tumor control, when gross total removal is performed. However, the efficacy of PDT for non-totally resectable malignant glioma has not been clearly confirmed. Therefore, the purpose of this study was to clarify the usefulness of PDT using talaporfin sodium for non-totally resectable malignant glioma.
Methods:
Eighteen patients with malignant glioma (16 new onset, 2 recurrent) in whom gross total removal was judged to be difficult from the images obtained before surgery were evaluated. Fifteen patients had glioblastoma (14 newly diagnosed, 1 recurrent), and 3 patients had anaplastic oligodendroglioma (2 newly diagnosed, 1 recurrent). The whole resection cavity was subjected to PDT during the surgery. For newly diagnosed glioblastoma, postoperative therapy involved the combined use of radiation and temozolomide. Bevacizumab treatment was also started at an early stage after surgery.
Results:
In some patients, reduction of the residual tumor was observed at an early stage of chemoradiotherapy after the surgery, suggesting the positive effect of PDT. Recurrence occurred in 15 of the 18 patients during the course of treatment. Distant recurrence occurred in 8 of these 15 patients, despite good local tumor control. In the 14 patients with newly diagnosed glioblastoma, the median progression-free survival was almost 10.5 months, and the median overall survival was almost 16.9 months.
Conclusions:
PDT for malignant glioma is expected to slightly improve local tumor control for non-totally resectable lesions.
Insights
Photodynamic therapy (PDT) using talaporfin sodium may offer slight improvements in local tumor control for malignant glioma that is not totally resectable. Further research is needed to confirm its overall efficacy in these challenging cases.
Area of Science:
- Oncology
- Neurosurgery
- Photodynamic Therapy
Background:
- Intraoperative photodynamic therapy (PDT) with talaporfin sodium is effective for malignant glioma with gross total removal.
- The efficacy of PDT for non-totally resectable malignant glioma remains unclear.
- This study aimed to evaluate talaporfin sodium PDT for malignant glioma where complete resection is difficult.
Purpose of the Study:
- To clarify the usefulness of talaporfin sodium photodynamic therapy (PDT) for non-totally resectable malignant glioma.
- To assess the impact of PDT on local tumor control and patient outcomes in this specific glioma subtype.
Main Methods:
- Eighteen patients with non-totally resectable malignant glioma underwent intraoperative PDT using talaporfin sodium.
- The study included patients with glioblastoma and anaplastic oligodendroglioma.
- Postoperative treatment involved chemoradiotherapy (radiation and temozolomide) and bevacizumab for newly diagnosed glioblastoma.
Main Results:
- Some patients showed early residual tumor reduction post-PDT and chemoradiotherapy.
- Recurrence occurred in 15 of 18 patients, with 8 experiencing distant recurrence despite good local control.
- For newly diagnosed glioblastoma, median progression-free survival was 10.5 months and median overall survival was 16.9 months.
Conclusions:
- Photodynamic therapy (PDT) using talaporfin sodium may offer a slight improvement in local tumor control for non-totally resectable malignant glioma.
- While local control might be enhanced, overall survival and recurrence rates require further investigation and management strategies.
