<title>Photodynamic therapy of supratentorial gliomas</title>

Abstract

We are updating the results of PDT treatment in 84 patients with supratentorial gliomas. These patients received 2 mg/kg Photofin iv. 12-36 hours prior to surgical resection of their tumor or tumor cyst drainage. There were 64 recurrent patients who had failed previous surgery and radiotherapy. The energy density range was 8 -150 J/cm 2 and the delivered light energy range was 440 - 7200 J (median=1700J). The median survival times in weeks for recurrent glioblastoma (37 patients), malignant astrocytoma (16 patients), malignant mixed astrocytoma-oligodentroglioma (7 patients) and ependymoma (4 patients) were 31, 50, >64 and >261 weeks, respectively. The thirteen patients with recurrent GBM who received >50 J/cm 2 had a median survival of 51 weeks. The eight patients with recurrent GBM who received >60 J/cm 2 had a median survival of 58 weeks. The mortality rate in our total series of 96 PDT treatments for brain tumor (metastatic and non glial primary tumors included) is 3%. The combined serious mortality-morbidity rate is 8%. Patients with malignant astrocytic tumors (GBM and MA) have a very poor prognosis. Nevertheless, PDT is safe in patients with either newly diagnosed or recurrent supratentorial malignant gliomas. There appears to be prolongation of survival in selected patients when an adequate light dose is used. Further improvement in survival may be expected with higher light doses.