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Phase II Trial of Debulking Surgery and Photodynamic Therapy for Disseminated Intraperitoneal Tumors

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Abstract

Background: Photodynamic therapy (PDT) combines photosensitizer drug, oxygen, and laser light to kill tumor cells on surfaces. This is the initial report of our phase II trial, designed to evaluate the effectiveness of surgical debulking and PDT in carcinomatosis and sarcomatosis.

Methods: Fifty-six patients were enrolled between April 1997 and January 2000. Patients were given Photofrin (2.5 mg/kg) intravenously 2 days before tumor-debulking surgery. Laser light was delivered to all peritoneal surfaces. Patients were followed with CT scans and laparoscopy to evaluate responses to treatment.

Results: Forty-two patients were adequately debulked at surgery; these comprise the treatment group. There were 14 GI malignancies, 12 ovarian cancers and 15 sarcomas. Actuarial median survival was 21 months. Median time to recurrence was 3 months (range, 1–21 months). The most common serious toxicities were anemia (38%), liver function test (LFT) abnormalities (26%), and gastrointestinal toxicities(19%), and one patient died. Conclusions: Photofrin PDT for carcinomatosis has been successfully administered to 42 patients, with acceptable toxicity. The median survival of 21 months exceeds our expectations; however, the relative contribution of surgical resection versus PDT is unknown. Deficiencies in photosensitizer delivery, tissue oxygenation, or laser light distribution leading to recurrences may be addressed through the future use of new photosensitizers.

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Authors and Affiliations

  1. Departments of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania

    Samantha K. Hendren MD, Francis R. Spitz MD, Todd W. Bauer MD & Douglas L. Fraker MD

  2. Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania

    Stephen M. Hahn MD, Timothy Zhu PhD & Eli Glatstein MD

  3. Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania

    Stephen C. Rubin MD

  4. University of Pennsylvania Department of Surgery, 3400 Spruce Street, 4 Silverstein, Philadelphia, PA, 19104

    Douglas L. Fraker MD

Authors
  1. Samantha K. Hendren MD
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  2. Stephen M. Hahn MD
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  3. Francis R. Spitz MD
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  4. Todd W. Bauer MD
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  5. Stephen C. Rubin MD
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  6. Timothy Zhu PhD
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  7. Eli Glatstein MD
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  8. Douglas L. Fraker MD
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Hendren, S.K., Hahn, S.M., Spitz, F.R. et al. Phase II Trial of Debulking Surgery and Photodynamic Therapy for Disseminated Intraperitoneal Tumors. Ann Surg Oncol 8, 65–71 (2001). https://doi.org/10.1007/s10434-001-0065-x

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  • DOI: https://doi.org/10.1007/s10434-001-0065-x

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