Korean J Obstet Gynecol.  2010 Dec;53(12):1092-1099. 10.5468/kjog.2010.53.12.1092.

Photodynamic therapy using topically applied 5-aminolevulinic acid for treatment of cervical cancer

Affiliations
  • 1Department of Obstetrics and Gynecology, Dankook University College of Medicine, Cheonan, Korea. parkdkog@dankook.ac.kr
  • 2Medical Laser Research Center, Dankook University, Cheonan, Korea.

Abstract


OBJECTIVE
The purpose of this study was to investigate the treatment effects of a topical application of 5-aminolevulinic acid (5-ALA) for photodynamic therapy (PDT) to treat cervical cancer.
METHODS
We first investigated the effects of 5-ALA cream according to application time. And to find the effective 5-ALA concentration and the distribution times in vivo, 20% 5-ALA cream was topically applied to the tumor of the nude mouse. We then observed the distribution of 5-ALA via fluorescence measurement with using a 532 nm diode laser. 25 nude mice were divided into Control, ALA, Laser, and PDT group. To evaluate the PDT effect at cancer lesion, we applied 20% 5-ALA cream to the tumor by the same method, and the PDT was done by using a 632 nm diode laser at the time of the peak level of fluorescence. We checked the changes of the volume of cancer for 30 days, and then biopsy was done.
RESULTS
The effective post-irradiation time after topical ALA application was 9 hours. In the PDT group, 40% (4/10) of the mice showed decreased tumor size.
CONCLUSION
The maximum PpIX fluorescence at 9 hours after local applicationof 5-ALA cream was checked. And PDT group did not show any statistical difference than control group in the growth of tumor size than control group. However responding cases (4/10) of PDT group showed the meaningful decrease of tumor size than control group (P<0.05).

Keyword

Photodynamic therapy; 5-Aminolevulinic acid; Cervical cancer

MeSH Terms

Animals
Biopsy
Fluorescence
Lasers, Semiconductor
Mice
Mice, Nude
Photochemotherapy
Protoporphyrins
Triazenes
Uterine Cervical Neoplasms
Protoporphyrins
Triazenes

Figure

  • Fig. 1 The application of 5-aminolevulinic acid cream was occluded during the whole application period by covering the mouse all around with an adhesive dressing (A). The mice were given 480 J/cm2 of 632 nm diode laser on the skin overlying the tumor for 20 minutes (B). The tumor was recorded every 3 days after photodynamic therapy (PDT) (C: Before PDT, D: 9 days, E: 21 days, F: 30 days).

  • Fig. 2 The effective 5-aminolevulinic acid distribution times were measured by the degree of fluorescence of PpIX with using a 532 nm diode laser. The .most effective distribution time after ALA injection was 9 hours.

  • Fig. 3 Comparison of the tumor volume changes of the xenografted tumor of HeLa cancer cells in nude mouse according to four different groups. * Statistically significant difference between control and group IV respond group.

  • Fig. 4 These pictures shows histological changes of xenografted tumor of HeLa cervical cancer cells in nude mouse at 30 days after photodynamic therapy in Group 4. The tumor size was decreased grossly, and there are small amounts of cancer tissue microscopically (H&E stain). Group 4 (partial remission): (A) ×40, (B) ×200.


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