Experience of using photodynamic therapy in early stages of penile cancer

Abstract

Background. Penile cancer is a rare oncological pathology. Due to the intimate nature of the affected area and high significance of the organ for psycho-emotional state of the patient, at the early stages of the disease organ-sparing operations are preferred allowing to minimize the effect on patient’s quality of life without affecting oncological results.Aim. To evaluate the effectiveness of treatment of early stages penile cancer using photodynamic therapy (PDT) with chlorin E6 derivatives.Materials and methods. Between 2017 and 2021, PDT with chlorin E6 derivatives to treat early-stage penile cancer was performed in 15 patients between the ages of 29 and 84 years (mean age 56.4 years). Tumor stage was Tin situ–1bN0M0. PDT was performed with preliminary administration of Photolon and Photoran photosensitizers. Laser exposure on the tumor lesions was performed 3 hours after photosensitizer administration using laser device Latus-2 (662 nm), light dose 200–300 J/cm2, power density 0.21–0.41 mW/cm2.Results. After 1 PDT session, full regression was observed in 11 (73.3 %) patients, partial regression in 4 (26.7 %) patients who underwent 2nd session 2 months later with full effect. Therefore, in all patients full regression of the tumors was achieved. Follow-up duration was 6–56 months. Recurrence was diagnosed in 1 (6.7 %) patient 36 months after PDT, 14 (93.3 %) patients are under observation without signs of local recurrence, among them for more than 4 years – 3 men, more than 3 years – 1, more than 2 years – 3, more than 1 year – 4 and more than 6 months – 3. During the follow-up, no regional or distant metastases were observed in any of the patients.Conclusion. PDT with chlorin E6 derivatives is an effective organ-sparing treatment method for early-stage penile cancer with satisfactory oncological results without negative effect on patients’ quality of life. In 93.3 % of patients, local recurrence of the disease was not observed; during follow-up no distant metastases were diagnosed. It is necessary to point out satisfactory cosmetic results of the treatment: in all patients, elastic non-deforming scars were formed with full preservation of anatomical structures of the penis, no erectile dysfunction or disruption of urination were observed after PDT.