Photodynamic therapy for ciliary body melanoma: experience with an isolated transscleral approach

Management of Choroidal Neovascular Membranes Associated with Choroidal Nevi

Robotic CyberKnife Radiosurgery for the Treatment of Choroidal and Ciliary Body Melanoma

Prognostic associations of insulin-like growth factor-1 receptor in primary uveal melanoma

To establish whether the presentation of choroidal and ciliary body melanomas and patient survival have changed during the period 1955-2000. The study included 209 unselected patients (97 men, 112 women) from Arhus County during the period 1955-2000. The median age at treatment was 64 years (range 26-88 years). The disease course from first symptom through clinical and histopathological findings to death was described in a historical follow-up design. Time trends were evaluated. Treatment modality changed over time from enucleation to an almost equal distribution between enucleation and radiation brachytherapy. The age at treatment, or, alternatively, at diagnosis, increased significantly (p = 0.04). No significant time trend was seen for largest basal tumour diameter (p = 0.08) or tumour height (p = 0.27). The clinical and histopathological findings did not show any consistent time trends. No significant time trend was found for melanoma-specific survival (p = 0.96) or overall survival (p = 0.33). No consistent time trends were seen in clinical and histopathological tumour presentation and survival in patients with choroidal or ciliary body melanomas. The increase in age at treatment was in line with an increase in life expectancy in Denmark.

To compare distribution of macrophages in extratumoural ocular tissues in enucleated eyes with irradiated and nonirradiated uveal melanomas to find out how irradiation affects distribution of macrophages so as to gain insight into their potential routes of migration and changes in local inflammatory responses. Thirty-four matched pairs of primarily enucleated nonirradiated and secondarily enucleated irradiated eyes with choroidal and ciliary body melanoma were stained with mAb PG-M1, and the extratumoural immunopositive elements were counted under the microscope. Main outcome variables were the number of macrophages in the sclera underlying the tumour, in the choroid adjacent to the tumour, and in the ciliary body. The number of macrophage aggregates in the anterior ipsi- and contralateral episclera adjacent to the limbus was also counted. Macrophages were more numerous within the sclera under the tumour in irradiated eyes when compared to primarily enucleated eyes (median 1514 versus 619/mm², p = 0.0001), and more aggregates of episcleral macrophages adjacent to the limbus were found after irradiation (ipsilateral side, median 132 versus 0, p = 0.0034; contralateral side, median 79 versus 0, p = 0.014). In primarily enucleated eyes, increasing numbers of tumour-infiltrating macrophages were associated with presence of higher numbers of macrophages in the ciliary body (p = 0.003) and the adjacent choroid (p = 0.044), whereas in the irradiated eyes, increasing numbers of tumour-infiltrating macrophages (p = 0.010) and increasing extent of necrosis (p < 0.001) were associated with higher numbers of intrascleral macrophages underlying the tumour. Resident macrophages are present in extratumoural tissues in eyes with uveal melanoma. Brachytherapy may alter their route of migration and increase the number of macrophages in the sclera and episclera. Histopathologically detectable episcleral aggregates of macrophages adjacent to the limbus are detected predominantly after irradiation, a population of which is clinically visible as episcleral deposits after irradiation.

Cysts of the Iris Pigment Epithelium. What Is New and Interesting? The 2016 Jose Rizal International Medal Lecture.

Introduction. The current direction of scientific research in experimental and clinical oncology is radiodynamic therapy (RDT), a treatment method based on the activation of photosensitizers (PS) by ionizing radiation. As the results of in vitro / in vivo studies show, a number of photosensitizing agents have radiomodifying properties, and the method itself is characterized by high antitumor efficacy.Aim. To study the possibility of increasing the effectiveness of photodynamic therapy (PDT) through its combined use with RDT in an in vivo experiment.Materials and methods. The work was performed on 26 white non-linear rats weighing 180 ± 50 g. Pliss lymphosarcoma was used as a tumor model, which was transplanted subcutaneously. The chlorine-based PS (Belmedpreparaty, Republic of Belarus) was administered intravenously at a dose of 2.5 mg / kg of body weight. The RDT session was performed by the contact method (CRT) after 2.5–3, 24 and 48 hours after the end of PS administration on the microSelectron-HDR V3 Digital device (Elekta, Sweden) using γ-radiation (192Ir) in a single focal dose (SFD) of 2 Gy until the total focal dose of 6 Gy is reached. A PDT session was performed once immediately after the first exposure to ionizing radiation using a PDT diode laser (Imaf Axicon, Republic of Belarus, λ = 660 ± 5 nm) at an exposure dose of 100 J / cm² with a power density of 0.2 w / cm² and a power of 0.353 w. All rats were divided into 4 groups of 6–7 animals each: intact control, PS + PDT, PS + CRT, PS + CRT + PDT. The criteria for evaluating antitumor efficacy were: the average volume of tumors (Vav), the coefficient of absolute growth of tumors (K), the coefficient of tumor growth inhibition (TGI), the frequency of complete tumor regressions (CR), the proportion of cured rats, an increase in the average duration of dead rats. Differences were considered statistically significant at p &lt;0.05.Results. On the 18th day of the experiment, Vav in groups was 65.98 ± 0.81 cm³; 24.02 ± 4.01 cm³ (р &lt;0.00001); 17.11 ± 4.13 cm³ (р &lt;0.00001); 4.42 ± 1.65 cm³ (р &lt;0.00001), respectively. Coefficients K – 5497.33 OE; 1714.71 OE; 1424.83 OE; 367.33 OE. TGI coefficients – 63.60 % (PS + PDT); 74.07 % (PS + CRT); 93.30 % (PS + CRT + PDT). An in crease in the average duration of dead rats indicator – 25.31 % (PS + PDT); 55.06 % (PS + CRT); 158.22 % (PS + CRT + PDT). On the 60th and 90th days of the experiment, the frequency of CR and the proportion of cured rats were the same and amounted to 0; 16.7; 14.3 and 42.9 %, respectively.Conclusion. The results obtained indicate that the chlorine PS has, in addition to photosensitizing properties, also radiomodifying properties, and the developed method of combined therapy is characterized by high antitumor efficacy.

Frameless Multisession Radiosurgery for Symptomatic Circumscribed Choroidal Hemangioma

Timing of Complete Polypoidal Regression after Intravitreous Aflibercept Treatments in Polypoidal Choroidal Vasculopathy

The results of clinical study for efficacy of photodynamic therapy (PDT) with radachlorine in patients with pre-cancer and cancer of cervix are represented. The study enrolled 30 patients including 4 patients with cervical erosion, 5 patients with cervical intraepithelial neoplasia II, 13 patients with cervical intraepithelial neoplasia III, 4 patients with carcinoma in situ and 4 patients with cervical cancer stage Ia. Radachlorine was administrated as single 30 minute intravenous injection at dose of 1,0 mg/kg of body weight 3 h before irradiation (wavelength of 662 nm, light dose of 300–350 J/cm 2 ). The results of treatment in 26 (86,7%) patients was assessed as complete tumor regression and in 4 (13,3%) patients — as partial regression. In cervical erosion, intraepithelial neoplasia II and carcinoma in situ groups total regression was in all cases. In the cervical intraepithelial neoplasia III group total regression after first course of PDT was achieved in 77% of patients, in cervical cancer stage Ia group – in 75% of patients. From 3 to 6 months after first course of treatment all patients with partial tumor regression underwent the second course of PDT with complete regression. There were no side-effects due to radachorine or PDT in the course of treatment and during follow-up. Thus, PDT with Russian photosensitizer radachlorine showed high efficiency for treatment of pre-cancer and cancer of cervix.

The article provides an example of successful treatment of a patient with basal cell skin cancer of the lower eyelid of the right eye, stage IB cT2aN0M0, with the presence of concomitant pathology – a decrease in the activity of plasma factor XII of blood coagulation (Hageman disease). The patient’s medical history is associated with long-term ineffective treatment of the tumor with Curaderm ointment. After diagnosis and further examination at the Moscow Research Institute named after. P.A. Herzen, at the Center for Laser and Photodynamic Diagnostics and Therapy of Tumors, the patient underwent organ-preserving treatment using photodynamic therapy. 1 course of photodynamic therapy with the photosensitizer chlorin e6 was carried out. Complete tumor regression was obtained; relapse-free follow-up period was 1 year

Near-infrared phototheranostics of tumors with protoporphyrin IX and chlorin e6 photosensitizers

To investigate the impact of pretreatment tumor growth on survival in patients with primary posterior uveal melanoma. Retrospective case-by-case matched comparative survival study. Thirty patients with documented tumor growth of at least 3 mm in basal diameter, 1.5 mm in thickness, or both during a pretreatment interval of 6 months or more and a matched control group of 30 promptly treated patients. Matching criteria included patient age (+/- 10 years), largest basal tumor diameter (+/- 2 mm), tumor thickness (+/- 1.5 mm), location of anterior tumor margin (same defined zone), and visual symptoms (present or absent). The Oncology Unit of the Retina Service at Wills Eye Hospital, Philadelphia, Pa. All patients were treated in a nonrandomized fashion by conventional therapeutic methods appropriate to the tumor's size, location, and other factors. Actuarial melanoma-specific mortality and all-cause mortality. The mean +/- SE cumulative 5-year probability of melanoma-specific mortality relative to the date of initial examination was 17.1% +/- 7% in the delayed treatment group and 18.4% +/- 8% in the prompt treatment group. This difference is not statistically significant (P > .5, log rank test). These results lend support to the belief that delayed treatment of selected small and dormant-appearing choroidal and ciliary body melanomas does not substantially increase the probability of melanoma-specific mortality; however, they do not prove that observation is the correct management option for all patients with a posterior uveal melanoma.

We have analyzed the results of photodynamic therapy using light-sensitizing agent "Photoheme" in 56 patients - 44 women with pre-cancerous lesions of cervix (group 1) and 12 women with early cervical cancer (group 2). The results were as follows: group 1 - c omplete regression - 3 7 (84%), partial regression - 4 (9,%), stabilization - 2 (4,6%), progression -1 (2,3%); group 2 - complete regression - 8 (66,7%), partial regression - 1 (8,3%), stabilization - 3 (25%). Anti-viral effect was registered in 38 (90,4%) cases after first procedure, in 4 cases - after second procedure.

Outcomes after photodynamic therapy (PDT) in 33 patients with basal cell skin cancer Т3-Т4N0M0 primary stage are represented in the article. The irradiation was performed distantly 3h after intravenous injection of photosensitizer photolon with dose 0.8-1.0 mg/kg; light dose accounted for 200-400 J/cm 2 . Distant PDT was applied as monotherapy or in combination with electrochemical lysis, radiotherapy or interstitial PDT. 84.6% of patients with Т3N0M0 stage basal cell skin carcinoma had complete regression, 15.4% of patients – partial regression. The treatment for Т4N0M0 stage basal cell skin carcinoma was palliative and in 100% of cases it allows to shrink the tumor (defined as partial tumor regression), retard the progression time, improve quality of life. Interstitial PDT and electrochemical lysis improved the efficacy of distant PDT (increased volume of tumor destruction) and, thus, allowed to decrease treatment period. Combination of PDT with radiotherapy allowed to decrease radiation dose for 20-30% and, thus, to decrease the risk of radiation-induced complications.