Fluorescence diagnosis and photodynamic therapy in intra-abdominal gynecologic diseases and breast cancer – A review

Abstract

Abstract Fluorescence diagnosis (FD) and photodynamic therapy (PDT) with 5-aminolevulinic acid (5-ALA)-induced protoporpyrin IX are promising new options in the diagnosis and therapy of diseases in a wide spectrum of medical disciplines such as urology, dermatology, gastroenterology and neurosurgery. FD is based on the application of the heme precursor 5-ALA which induces the endogenous accumulation of the photosensitizer protoporphyrin IX (PpIX) in designated tissues. After excitation with blue light, a strong red fluorescence can be initiated particularly in tumorous tissues. PDT involves the use of photochemical reactions mediated through the interaction of photosensitizing agents, light and oxygen for the treatment of malignant or benign diseases. In gynecology, many studies have been performed which evaluate the usefulness of FD and PDT of breast cancer, endometrial diseases, ovarian cancer and endometriosis. This work aims to show the current status in these gynecological diseases. The use of PDT in intra-abdominal tumor tissues is not currently relevant because of the difficulty in selective application, and the side effects provoking peritoneal ascites. However, for breast cancer PDT offers the possibility of effective control of recurrent disease for patients after radiation therapy. Endometrial ablation using PDT is both feasible and effective. Well-designed studies are now needed to transfer these promising diagnostic and therapeutic methods to clinical practice.