Photodynamic therapy using meso tetra hydroxy phenyl chlorin (mTHPC) in early prostate cancer.
OBJECTIVE
Prostate cancer is increasing in incidence, but current treatments including surgery and radiotherapy have significant side effects. This pilot study was designed to assess the potential of photodynamic therapy (PDT) using meso tetra hydroxy phenyl chlorin (mTHPC) for organ confined prostate cancer.


METHODS
Six men with organ confined prostate cancer were photosensitised with mTHPC (0.15 mg/kg). Between 2 and 5 days later, red light (652 nm) was delivered to areas of biopsy proven cancer via fibres inserted through transperineal needles (50-100 J per site).


RESULTS
After 8 of 10 PDT sessions, the prostate specific antigen (PSA) fell by up to 67%. Early MRI scans showed oedema and patchy necrosis, which resolved over 2 months. Biopsies of treated areas revealed necrosis and fibrosis at 1-2 months.


CONCLUSIONS
PDT for primary prostate cancer appears safe and can reduce PSA levels. As this was a phase I study, no attempt was made to treat the whole prostate; this or targeted tumour ablation could be attempted in a phase II study with an increased number of fibres. This technique merits further investigation in early prostate cancer.
Moore
C M
CM
National Medical Laser Centre, University College London, London W1W 7EJ, England. carolinemoore@doctors.org.uk
Nathan
T R
TR
Lees
W R
WR
Mosse
C A
CA
Freeman
A
A
Emberton
M
M
Bown
S G
SG
D000368:Aged; D001706:Biopsy; D005355:Fibrosis / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008652:Mesoporphyrins / Q000627:therapeutic use*; D008875:Middle Aged; D009336:Necrosis / Q000209:etiology; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D010865:Pilot Projects; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D016896:Treatment Outcome
D008652:Mesoporphyrins; D017319:Photosensitizing Agents; D017430:Prostate-Specific Antigen; C072269:temoporfin