title: Cytoreductive surgery under aminolevulinic acid-mediated photodynamic diagnosis plus hyperthermic intraperitoneal chemotherapy in patients with peritoneal carcinomatosis from ovarian cancer and primary peritoneal carcinoma: results of a phase I trial.
abstract: BACKGROUND
  We conducted a phase I clinical trial to evaluate the sensitivity, specificity, and safety of cytoreductive surgery (CRS) under aminolevulinic acid-mediated photodynamic diagnosis (ALA-PDD) plus hyperthermic intraperitoneal chemotherapy (HIPEC) on 20 patients with peritoneal carcinomatosis (PC) from ovarian cancer and primary peritoneal carcinoma (PPC).
  
  
  METHODS
  Patients took 5-aminolevulinic acid (5-ALA) at a dose of 20 mg/kg orally with 50 mL of water 2 h before surgery. During surgery, the abdominal cavity was observed under blue light (wavelength of 440 nm) before and after CRS plus HIPEC. Specimens were excised and submitted for pathological examination to evaluate the specificity of ALA-PDD. Postoperative course was closely monitored and detailed information was recorded.
  
  
  RESULTS
  CRS under ALA-PDD plus HIPEC was performed 21 times in 20 patients with PC (16 ovarian cancer, 4 PPC) between June 2011 and October 2013. With the exception of 1 (5 %) patient, strong red fluorescence was detected in 19 patients with ovarian cancer, with a sensitivity of 95 %. All specimens from red fluorescent lesions were invaded by cancer cells, with a specificity of 100 %. No severe adverse events occurred during the perioperative period, with the exception of some abnormal laboratory results and mild complications. All patients were alive until the last follow-up.
  
  
  CONCLUSIONS
  ALA-PDD provided a high sensitivity and specificity in detecting peritoneal metastasis in patients with PC from ovarian serous carcinoma and PPC. CRS under ALA-PDD plus HIPEC was a feasible and safe treatment option for patients with PC from ovarian cancer and PPC.
authors: NPO to Support Peritoneal Dissemination Treatment, 1-26 Haruki-Moto-Machi, Osaka, 596-0032, Japan.
authors: Yang
authors: Y
authors: Liu
authors: Yoshio
authors: Y
authors: Endo
authors: Takuji
authors: T
authors: Fujita
authors: Haruaki
authors: H
authors: Ishibashi
authors: Toshihiro
authors: T
authors: Nishioka
authors: Emel
authors: E
authors: Canbay
authors: Yan
authors: Y
authors: Li
authors: Shun-Ichiro
authors: S
authors: Ogura
authors: Yutaka
authors: Y
authors: Yonemura
mesh_terms: D000368:Aged; D000622:Aminolevulinic Acid; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002291:Carcinoma, Papillary / Q000473:pathology* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D010478:Chemotherapy, Cancer, Regional Perfusion; D003131:Combined Modality Therapy; D018284:Cystadenocarcinoma, Serous / Q000473:pathology* / Q000628:therapy; D065426:Cytoreduction Surgical Procedures; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D007274:Injections, Intraperitoneal; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000628:therapy; D010534:Peritoneal Neoplasms / Q000556:secondary* / Q000628:therapy; D017319:Photosensitizing Agents; D011379:Prognosis; D015996:Survival Rate
chemical_list: D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid