Abstract
Pleural photodynamic therapy (PDT) has been used as an adjuvant treatment with lung-sparing surgical treatment for malignant pleural mesothelioma (MPM). In the current pleural PDT protocol, a moving fiber-based point source is used to deliver the light. The light fluences at multiple locations are monitored by several isotropic detectors placed in the pleural cavity. To improve the delivery of light fluence uniformity, an infrared (IR) navigation system is used to track the motion of the light source in real-time at a rate of 20 - 60 Hz. A treatment planning system uses the laser source positions obtained from the IR camera to calculate light fluence distribution to monitor the light fluence uniformity on the surface of the pleural cavity. A novel reconstruction algorithm is used to determine the pleural cavity surface contour. A dual-correction method is used to match the calculated fluences at detector locations to the detector readings. Preliminary data from a phantom shows superior light uniformity using this method. Light fluence uniformity from patient treatments is also shown with and without the correction method.
Highlights
Malignant pleural mesothelioma (MPM) is an aggressive cancer with a median survival of less than 1 year
An early study involved 40 MPM patients treated by adjuvant pleural Photodynamic therapy (PDT) using the first generation photosensitizer Photofrin
A phase III trial was carried out at NIH on 63 MPM patients for adjuvant pleural PDT using Photofrin, and no difference in median survival was found in this study [14]
Summary
Malignant pleural mesothelioma (MPM) is an aggressive cancer with a median survival of less than 1 year. A phase III trial was carried out at NIH on 63 MPM patients for adjuvant pleural PDT using Photofrin, and no difference in median survival was found in this study [14]. At the Hospital of the University of Pennsylvania, a phase II trail of MPM pleural PDT and surgery was conducted, and survival of more than 2.1 years was achieved in 14 patients undergoing radical pleurectomy, a lung-sparing cytoreduction technique, with adjuvant pleural PDT [2]. The dosimetry for the latter four studies involved isotropic light detectors to monitor the PDT light fluence directly during the procedure
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