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Dosimetry recommendations for NMIBC: a simulation and in vivo study (Conference Presentation) NMIBC的剂量学建议:模拟和体内研究(会议报告)
Pub Date : 2019-08-14 DOI: 10.1117/12.2526079
L. Lilge, Daniel Molehuis, A. Manalac, Fynn Schwiegelshohn, Vaughn Betz, Wayne Embree, A. Mandel, R. Dumoulin-White, G. Kulkani, M. Jewett
Recurrent Non-Muscle Invasive Bladder Cancer (NMIBC) is a diffuse disease, and patients have failed standard BCG therapy face prophylactic cystectomy. PDT fell out of favour due to its variable outcome, and high morbidity. To overcome PDT associate toxicity to the bladder’s muscle layer, the use of shorter wavelength and instillation of the photosensitizer were suggested. While either approach was shown to improve the outcome in animal models they have not previously combined in human studies. Additionally, the effects of highly variable tissue optical properties of the bladder and its shape have not been studied. Here, we present surface dose histograms derived from light propagation simulation in 6 human bladders using CT images for anatomical detail and the FullMonte software package. The ability of a single light sensor versus 3 or 12 light sensors to measure the average irradiance on the bladder surface was evaluated as a function of the bladder wall’s tissue optical properties. Results show that the irradiance in non-spherical bladders can vary over an order of magnitude, but the irradiance histograms are affected little by displacement of the emitter inside the bladder void. As the surface area monitored by a single sensor depends strongly on the bladder shape, the responsivity of a single sensor to the average bladder irradiance can vary equally. Twelve light sensors monitor the entire bladder surface almost complete and hence their average responsivity is constant to the average irradiance on the bladder largely independent of shape. The dependency of the sensor’s response on the tissue optical properties is also lower.
复发性非肌肉浸润性膀胱癌(NMIBC)是一种弥漫性疾病,标准卡介苗治疗失败的患者面临预防性膀胱切除术。PDT因其结果多变和发病率高而失宠。为了克服PDT对膀胱肌层的相关毒性,建议使用更短的波长和注入光敏剂。虽然这两种方法在动物模型中都被证明可以改善结果,但它们以前没有在人类研究中结合起来。此外,膀胱高度可变的组织光学特性及其形状的影响尚未研究。在这里,我们使用CT图像和FullMonte软件包展示了6个人膀胱的表面剂量直方图,这些图像是通过光传播模拟得到的,用于解剖细节。单个光传感器与3个或12个光传感器测量膀胱表面平均辐照度的能力作为膀胱壁组织光学特性的函数进行了评估。结果表明,非球形膀胱内的辐照度可以发生一个数量级以上的变化,但辐照度直方图受发射器在膀胱内位移的影响很小。由于单个传感器监测的表面积在很大程度上取决于膀胱形状,因此单个传感器对膀胱平均辐照度的响应度可以均匀变化。12个光传感器监测整个膀胱表面几乎完整,因此它们的平均响应率与膀胱上的平均辐照度保持不变,在很大程度上与形状无关。传感器的响应对组织光学特性的依赖性也较低。
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引用次数: 0
Review of photochemical internalisation (PCI) applications (Conference Presentation) 光化学内在化(PCI)应用综述(会议报告)
Pub Date : 2019-08-14 DOI: 10.1117/12.2528406
A. Høgset, P. Walday
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引用次数: 0
Low-cost smartphone-based dosimeter for individualization of PDT treatment planning for protoporphyrin IX based skin cancer treatment (Conference Presentation) 基于智能手机的低成本剂量计用于基于原卟啉IX的皮肤癌治疗的个体化PDT治疗计划(会议报告)
Pub Date : 2019-08-14 DOI: 10.1117/12.2528176
Alberto J. Ruiz, E. LaRochelle, M. Chapman, B. Pogue
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引用次数: 0
Computational guided dosimetry for the safe and effective treatment of locally advanced VX2 carcinoma with interstitial photodynamic therapy (Conference Presentation) 计算引导剂量法安全有效地治疗局部晚期VX2癌的间质性光动力疗法(会议报告)
Pub Date : 2019-08-14 DOI: 10.1117/12.2525620
Emily Oakley, M. Habitzruther, Hannah Cooper, S. Sexton, Leslie I Curtin, Lawrence Tworek, M. Mallory, D. Bellnier, G. Shafirstein
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引用次数: 0
Enhancement of immunotoxin effect on tumor with photodynamic therapy (Conference Presentation) 光动力疗法增强免疫毒素对肿瘤的作用(会议报告)
Pub Date : 2019-08-14 DOI: 10.1117/12.2527654
T. Hamakubo
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引用次数: 0
Pretreatment planning and light dosimetry for interstitial PDT of locally advanced cancer (Conference Presentation) 局部晚期肿瘤间质PDT的预处理计划和光剂量测定(会议报告)
Pub Date : 2019-08-14 DOI: 10.1117/12.2527806
G. Shafirstein, D. Bellnier, Emily Oakley, M. Habitzruther, Hannah Cooper, Sarah Chamberlain, Sasheen Hamilton, A. Hutson, S. Sexton, Leslie I Curtin, J. Spernyak, Steven G. Turowski, H. Arshad, Lawrence Tworek, M. Mallory, B. Henderson
Pretreatment Planning and Light Dosimetry for Interstitial PDT of Locally Advanced CancerGal Shafirstein¹, David Bellnier¹, Emily Oakley¹, Michael Habitzruther¹, Sasheen Hamilton¹, Hannah Cooper¹, Sarah Chamberlain1, Alan Hutson2, Sandra Sexton3, Leslie Curtin3, Joe Spernyak4, Steven Turowski4, Hassan Arshad5, Lawrence Tworek¹, Matthew Mallory¹ and Barbara Henderson1. ¹ Photodynamic Therapy Center at the Department of Cell Stress Biology, and ² Department of Biostatistics and Bioinformatics, 3Laboratory Animals Shared Resources, 4Translational Imaging Shared Resource, 5Department of Head and Neck Surgery. Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA Objective: To highlight the critical need for pretreatment planning and light dosimetry in administering interstitial photodynamic therapy (I-PDT) in the treatment of locally advanced cancer (LAC). Background: There is no effective standard treatment for LAC that failed to respond to surgery and chemo-radiation. The newest immunotherapies are effective in only 5-16% of the cases. I-PDT can be considered if the target tumor does not invade a major blood vessel, and the tumor is accessible to fiber-optic placement. Multiple fibers are required for interstitial illumination of the target tumor and margins. Image-based pretreatment planning is used to determine the number and proposed location of fibers. Light dosimetry is employed to measure intratumoral light fluence and irradiance. To date, it was acceptable that a threshold intratumoral light fluence is required for adequate response. Whereas, we demonstrated that intratumoral light irradiance impacts tumor response [1].Overview: This talk will present an image-based finite element method (FEM) approach for guiding I-PDT. We will discuss the importance of delivering a threshold intratumoral light irradiance in addition to threshold fluence. We will demonstrate that even if a threshold fluence is delivered, an inadequate intratumoral irradiance will result in poor response. We will reveal that adequate light irradiance and fluence can yield up to 90% cure rate in mice and excellent local control in rabbits with LAC. We will present our image-based FEM and light dosimetry approach to translate the preclinical findings to test I-PDT in the treatment of patients with locally advanced head and neck cancer. References1.Shafirstein G, Bellnier DA, Oakley E, Hamilton S, Habitzruther M, Tworek L, Hutson A, Spernyak JA, Sexton S, Curtin L, Turowski SG, Arshad H, Henderson B. Irradiance controls photodynamic efficacy and tissue heating in experimental tumours: implication for interstitial PDT of locally advanced cancer. Br J Cancer. 2018;119(10):1191-9. Acknowledgements: Supported in part by NCI/NIH R01 CA193610 to GS, P01CA55791 to Sandra Gollnick, and by Roswell Park Comprehensive Cancer Center Support Grant P30CA16056. We thank Diane Filippini and Raymond Wasielewski for their assistance in obtaining the CT scans and Dr. Craig Hend
局部晚期肿瘤间质PDT的预处理计划与光剂量学研究[al Shafirstein¹,David Bellnier¹,Emily Oakley¹,Michael Habitzruther¹,Sasheen Hamilton¹,Hannah Cooper¹,Sarah Chamberlain1, Alan Hutson2, Sandra Sexton3, Leslie Curtin3, Joe Spernyak4, Steven Turowski4, Hassan Arshad5, Lawrence Tworek¹,Matthew Mallory¹,Barbara Henderson1]。1细胞应激生物学系光动力治疗中心,2生物统计与生物信息学学系,3实验动物共享资源,4转化成像共享资源,5头颈外科。目的:强调在局部晚期癌症(LAC)治疗中给予间质性光动力治疗(I-PDT)的预处理计划和光剂量学的关键需求。背景:对于手术和放化疗无效的LAC没有有效的标准治疗方法。最新的免疫疗法仅对5-16%的病例有效。如果目标肿瘤没有侵犯主要血管,并且肿瘤易于光纤放置,则可以考虑I-PDT。需要多种纤维来照亮肿瘤间质和边缘。基于图像的预处理规划用于确定纤维的数量和建议的位置。光剂量法用于测量肿瘤内的光影响和辐照度。迄今为止,可以接受的是,需要一个阈值的肿瘤内光影响才能产生充分的反应。然而,我们证明了肿瘤内光辐照度影响肿瘤反应[1]。概述:本次演讲将介绍一种基于图像的有限元方法(FEM)来指导I-PDT。除了阈值影响外,我们还将讨论提供阈值肿瘤内光辐照度的重要性。我们将证明,即使提供了阈值,瘤内辐照度不足也会导致不良反应。我们将揭示,适当的光照和影响可以在小鼠中产生高达90%的治愈率,并在患有LAC的兔子中产生良好的局部控制。我们将介绍基于图像的FEM和光剂量法方法,将临床前研究结果转化为I-PDT治疗局部晚期头颈癌患者的测试。References1。Shafirstein G, Bellnier DA, Oakley E, Hamilton S, Habitzruther M, Tworek L, Hutson A, Spernyak JA, Sexton S, Curtin L, Turowski SG, Arshad H, Henderson B.辐照对局部晚期肿瘤间质PDT的影响。中国生物医学工程学报,2018;39(5):391 - 391。致谢:部分由NCI/NIH R01 CA193610 to GS, P01CA55791 to Sandra Gollnick和Roswell Park综合癌症中心支持基金P30CA16056支持。我们感谢Diane Filippini和Raymond Wasielewski对CT扫描的帮助,感谢Craig Hendler博士对CT扫描的诊断。我们感谢罗斯威尔公园实验动物共享资源的工作人员。我们感谢Concordia Laboratories Inc.免费提供Photofrin®。
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引用次数: 0
Cancer PDT vaccines: progress and prospects (Conference Presentation) 癌症PDT疫苗:进展和前景(会议报告)
Pub Date : 2019-08-14 DOI: 10.1117/12.2528211
M. Korbelik
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引用次数: 1
Salvage photodynamic therapy using new generation photosensitizer for local failure after chemoradiotherapy for esophageal cancer (Conference Presentation) 新一代光敏剂对食管癌放化疗后局部失效的补救性光动力治疗(会议报告)
Pub Date : 2019-08-14 DOI: 10.1117/12.2538013
T. Yano, M. Muto
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引用次数: 0
TLD-1433 photodynamic therapy for BCG-unresponsive NMIBC: a Phase IB clinical study (Conference Presentation) TLD-1433光动力疗法治疗bcg无反应的NMIBC:一项IB期临床研究(会议报告)
Pub Date : 2019-08-14 DOI: 10.1117/12.2526187
L. Lilge, G. Kulkani, A. Mandel, N. Perlis, Michael E. Nesbitt, Roger White, Wayne Embree, M. Jewett
For patients failing standard Bacillus Calmette-Guerin based immunotherapy for Non-Muscle Invasive Bladder Cancer (NMIBC), PDT may delay or prevent cystectomy. A Phase IB clinical trial evaluated the feasibility and safety of TLD1433, a novel Ruthenium coordination-complex as photosensitizer (PS) for PDT. The clinical trial combined PS instillation for one hour and the use of strongly attenuated green (525nm) light to reduce PDT caused damage to the bladder wall. The low and high PS doses were defined as 0.35mg and 0.7mg TLD1433 per cm^2 bladder surface (N=3 each) and 90+/-9J/cm^2 as target radiant exposure on the bladder wall. The PS concentration in the urine and blood at 24hrs post instillation was below 1ng/ml indicating rapid drug clearing. In all patients, the average target radiant exposure was attained as verified by irradiance sensors in the bladder. The average measured irradiance was ~ 15mW/cm^2, never exceeding 35mW/cm2 at the sensor positions. At 30 days post-treatment, all patients receiving the low PS dose tolerated the procedure well with no grade 3, 4 or 5 AEs. Three patients were then treated at the Therapeutic Dose, again with no grade 3, 4 or 5 AEs, and an identical pharmacokinetic profile to the half dose. At half dose, all patients had recurrent, but no progressive NMIBC noted at the 180-day cystoscopy. At therapeutic dose, 2 of 3 patients were tumour-free at the 180-day cystoscopy. Moderate bladder irritability was reported at full dose which primarily resolved within 90 days.
对于非肌肉浸润性膀胱癌(NMIBC)的标准卡介苗- guerin免疫治疗失败的患者,PDT可能延迟或阻止膀胱切除术。一项IB期临床试验评估了TLD1433作为PDT光敏剂(PS)的可行性和安全性,TLD1433是一种新型钌配合物。临床试验结合PS滴注1小时和使用强衰减绿光(525nm)来减少PDT对膀胱壁的损伤。低剂量和高剂量分别为每cm^2膀胱表面0.35mg和0.7mg TLD1433 (N=3),膀胱壁靶辐射暴露为90+/-9J/cm^2。注药后24h尿液和血液中PS浓度低于1ng/ml,表明药物清除迅速。在所有患者中,通过膀胱中的辐照传感器验证,达到了平均目标辐射暴露。测量的平均辐照度为~ 15mW/ cm2,在传感器位置从未超过35mW/cm2。在治疗后30天,所有接受低PS剂量的患者都能很好地耐受治疗,没有3级、4级或5级不良反应。然后,三名患者接受治疗剂量,同样没有3级、4级或5级ae,并且与半剂量相同的药代动力学特征。在一半剂量时,所有患者复发,但在180天的膀胱镜检查中没有发现进展性NMIBC。在治疗剂量下,3例患者中有2例在180天膀胱镜检查时无肿瘤。据报道,在全剂量时,中度膀胱刺激在90天内基本缓解。
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引用次数: 3
Current clinical studies on 5-ALA-FD (5-aminolevulinic acid mediated-fluorescence guided detection) in detection of lung, gastric, pancreatic, and bladder cancers in Japan (Conference Presentation) 日本5-ALA-FD(5-氨基乙酰丙酸介导的荧光引导检测)检测肺癌、胃癌、胰腺癌和膀胱癌的临床研究现状(会议报告)
Pub Date : 2019-08-14 DOI: 10.1117/12.2527963
M. Nakajima
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引用次数: 0
期刊
17th International Photodynamic Association World Congress
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