Photodynamic selectivity of 5-aminolevulinic acid to prostate cancer cells.
OBJECTIVE
To determine the selectivity of 5-aminolevulinic acid (5-ALA) as a photosensitizer to malignant prostatic cells in men undergoing radical retropubic prostatectomy.


METHODS
Nineteen patients with localized prostate cancer were included in the study. Eighteen patients received 5-ALA and one patient did not receive it and was used as a control. The dose was 20mg /kg body weight, 15 patients received 5-ALA 4 hours before radical prostatectomy, two patients received it 2 hours before prostatectomy through a Ryle tube, and one patient received 5-ALA 12 hours before the operation. The removed prostates were examined for protoporphyrin IX (PpIX) fluorescence macroscopically, by fluorescence microscopy and by light microscopy.


RESULTS
All carcinomas showed a clear evidence of PpIX-enrichment except in the control case. The enrichments were strong (++) in 15 cases and weak (+) in 3 cases. Two of those three cases were given 5-ALA two hours through a Ryle tube before excision of the prostate as well as the patient who was given 5-ALA 12 hours preoperatively. No PpIX enrichment was observed in the stroma of the prostate gland or in the benign tissue sections in any case (0/19).


CONCLUSIONS
Oral 5-ALA is selectively concentrated in malignant cells of the prostate. This may lead to the clinical application of photodynamic therapy for localized prostate cancer.
Sultan
Sultan M
SM
The Department of Urology, Minoufiya University, Egypt. smasultan@yahoo.com
El-Doray
Abdel-Alim M
AA
Hofstetter
Alfons
A
Abdel-Gawad
Osama
O
El-Mahdy
Alaa El-Deen
Ael-D
Khoder
Wael
W
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000601:surgery; D000368:Aged; D000622:Aminolevulinic Acid / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D001682:Biological Availability; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000601:surgery; D012680:Sensitivity and Specificity
D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid