title: Photodynamic therapy in urology: what can we do now and where are we heading?
abstract: BACKGROUND
  Photodynamic therapy (PDT) is an innovative technique in oncologic urology. Its application appears increasingly realistic to all kind of cancers with technological progress made in treatment planning and light delivery associated with the emergence of novel photosensitizers. The aim of this study is to review applications of this technique in urology.
  
  
  METHODS
  We reviewed the literature on PDT for urological malignancies with the following key words: photodynamic therapy, prostate cancer, kidney cancer, urothelial cancer, penile cancer and then by cross-referencing from previously identified studies.
  
  
  RESULTS
  Focal therapy of prostate cancer is an application of PDT. Clinical studies are ongoing to determine PDT efficacy and safety. PDT as salvage treatment after radiotherapy has been tested. Oncologic results were promising but important side effects were reported. Individual dosimetric planning is necessary to avoid toxicity. PDT was tested to treat superficial bladder carcinoma with promising oncologic results. Serious side effects have limited use of first photosensitizers generation. Second generation of photosensitizer allowed reducing morbidity. For upper urinary tract carcinoma and urethra, data are limited. Few studies described PDT application in penile oncology for conservative management of carcinoma in situ and premalignant lesions. For renal cancer, PDT was only tested on preclinical model despite of its potential application. No data is available concerning PDT application for testicular cancer.
  
  
  CONCLUSIONS
  PDT clinical applications in urology have proved a kind of efficiency balanced with an important morbidity. Development of new photosensitizer generations and improvement in illumination protocols should permit to decrease side effects.
authors.affiliation: Department of Urology, Centre Hospitalier Regional Universitaire de Lille, avenue oscar lambret, Lille, France. bozzini gregory@yahoo.fr
authors.forename: G
authors.initials: G
authors.lastname: Bozzini
authors.forename: P
authors.initials: P
authors.lastname: Colin
authors.forename: N
authors.initials: N
authors.lastname: Betrouni
authors.forename: P
authors.initials: P
authors.lastname: Nevoux
authors.forename: A
authors.initials: A
authors.lastname: Ouzzane
authors.forename: P
authors.initials: P
authors.lastname: Puech
authors.forename: A
authors.initials: A
authors.lastname: Villers
authors.forename: S
authors.initials: S
authors.lastname: Mordon
mesh_terms: D019317:Evidence-Based Medicine; D006801:Humans; D008495:Medical Oncology / Q000639:trends; D010778:Photochemotherapy / Q000639:trends*; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D014571:Urologic Neoplasms / Q000188:drug therapy*; D014572:Urology / Q000639:trends*
chemical_list: D017319:Photosensitizing Agents