title: [Intraperitoneal photodynamic therapy for peritoneal metastasis of epithelial ovarian cancer. Limits and future prospects].
abstract: High peritoneal recurrence rate in advanced epithelial ovarian cancer after complete macroscopic cytoreductive surgery and platinum-based chemotherapy, raises the issue of peritoneal microscopic disease management and requires the development of additional locoregional treatment strategies. Photodynamic therapy is an effective treatment already applied in other medical and surgical indications. After administration of a photosensitizer which accumulates in cancer cells, illumination with a light of adequate wavelength may induce photochemical reaction between photosensitizer and tissue oxygen which lead to reactive oxygen species production and cytotoxic phenomenon. Photodynamic therapy's ability to treat superficial lesions disseminated on large area makes it an excellent candidate to insure destruction of microscopic peritoneal metastases in addition to macroscopic cytoreductive surgery in order to decrease peritoneal recurrence rate. Development of intraperitoneal photodynamic therapy has been limited by its poor tolerance related to the lack of specificity of photosensitizers and the location of the metastases in proximity to adjacent intraperitoneal organs. Our aim is to review clinical data concerning intraperitoneal photodynamic therapy and epithelial ovarian cancer to identify the limits of this strategy and to provide solutions which may be applied to solve these barriers and enable safe and effective treatment. Targeted photosensitizers and innovative illumination solutions are mandatory to continue research in this field and to consider the feasibility of clinical trials.
authors.affiliation: Service de chirurgie et cancérologie gynécologique et mammaire, hôpitaux universitaires Pitié Salpêtrière-Charles-Foix, AP-HP, 47/83, boulevard de l'Hôpital, 75013 Paris, France; U1189-ONCO THAI-Image Assisted Laser Therapy for Oncology, Inserm, CHU de Lille, 59000 Lille, France. Electronic address: henriazais@gmail.com.
authors.forename: H
authors.initials: H
authors.lastname: Azaïs
authors.affiliation: U1189-ONCO THAI-Image Assisted Laser Therapy for Oncology, Inserm, CHU de Lille, 59000 Lille, France.
authors.forename: S
authors.initials: S
authors.lastname: Mordon
authors.affiliation: U1189-ONCO THAI-Image Assisted Laser Therapy for Oncology, Inserm, CHU de Lille, 59000 Lille, France; Service de gynécologie medicochirurgicale, centre hospitalier régional et universitaire, 59000 Lille, France.
authors.forename: P
authors.initials: P
authors.lastname: Collinet
mesh_terms: D000077216:Carcinoma, Ovarian Epithelial; D003131:Combined Modality Therapy; D065426:Cytoreduction Surgical Procedures; D005260:Female; D006801:Humans; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D010537:Peritoneum / Q000187:drug effects; D010778:Photochemotherapy / Q000639:trends*; D017319:Photosensitizing Agents / Q000008:administration & dosage*
chemical_list: D017319:Photosensitizing Agents
keywords: Cancer de l’ovaire; Folate receptor; Ovarian cancer; Photodynamic therapy; Photosensibilisateur; Photosensitizer; Récepteur au folate; Thérapie photodynamique