Photodynamic therapy with systemic meta-tetrahydroxyphenylchlorin in the treatment of anal intraepithelial neoplasia, grade 3
Lasers in Surgery and Medicine, 08/17/2012
Evidence Based Medicine
van der Snoek EM et al. – The results show that the use of systemic meta–tetrahydroxyphenylchlorin is partially effective for the treatment of anal intraepithelial neoplasia 3.Methods
- In this prospective intervention study, 15 HIV–positive MSM with AIN 3 were treated in 25 PDT–sessions using mTHPC intravenously administered at drug doses of 0.075–0.15mgml–1 and illumination at 48hours.
- The illumination was performed using a custom made applicator using either red light (652nm) to a measured intended fluence of 10 and 20Jcm–2 and green light (532nm) to a measured intended fluence of 105, 210, and 340Jcm–2.
- Red and green illuminations were performed at a (green) equivalent fluence rate of 105mWcm–2.
- Initial complete response was seen in 7/25 (28%) of treatments and another 4/25 (16%) initial partial responses.
- After an average 8 months, recurrences were detected in 7/11 (64%) of sessions that initially showed response.
- A total 4/25 (16%) showed persistent complete response 6–15 months after green light illumination.
- Red light illuminations caused more significant side effects combined with no persistent complete response.
- Reported side effects were intense pain, bloody and purulent rectal discharge, and anal stricture formation, in one patient.