New Approach To Pancreatic Cancer With Photodynamic Therapy Gut 03/13/2002 By Harvey McConnell Initial pilot study success using photodynamic therapy among 16 patients with inoperable pancreatic cancer justifies larger studies to quantify its efficacy, British clinicians think. Compared with the average prognosis of six to 10 months survival, the trial by Dr Stephen Bown and colleagues at the National Medical Laser Centre, University College Hospital, London, England, led to almost 50 percent of patients with pancreatic cancer surviving for at least one year, two for two years and one for 30 months. Worldwide, pancreatic cancer probably ranks ninth among the leading causes of cancer mortality. At specialized centers, over 10 percent may be resectable at presentation but, in larger population based studies, the number undergoing resection with curative intentcan be as low as 2.6 percent, the clinicians said. Even after resection, median survival is only 12-18 months and no more than 10-20 percent of resected patients survive five years. The researchers gave intravenous photosensitising agent meso-tetrahydroxyphenyl chlorin to the 16 patients, aged between 46 and 77 years. Three days later, they inserted up to six needles carrying laser fibres delivering light through the skin and directly into the tumour. The photodynamic therapy shrank the area of viable tumour which, in most patients, had been large. Care is required for tumors invading the duodenal wall or involving the gastroduodenal artery. There were few serious side effects. Patients were able to start eating and drinking within 48 hours, and they left hospital 10 days later. Almost all of the patients were able to spend most of their survival time at home with their families. Dr Bown said that this is the first report of the use of photodynamic therapy to treat pancreatic cancer. The researchers conclude: "The technique may be of value for treating localized cancers in patients who are poor candidates for definitive surgery or in whom the location of the tumor makes pancreatic resection inappropriate. PDT can be used in conjunction with chemotherapy or radiotherapy. These promising early results justify larger trials to assess PDT either as a single therapy or in combination with chemotherapy and/or radiotherapy." GUT 2002;50:549-57. DGR Review www.docguide.com |
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